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RA982.P53  P53  1916  Blockley  days;  memor 


fmmmmamm^iLJwii 


RECAP 


BLOCKLEY  DAYS 


ARTHUR  AMES  BLISS 


CoUese  of  H^ffpaitiaxiS  anb  S>urgeons( 
ILilirarp 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/blockleydaysmemOOblis 


Blockley  Days 


Memories  and  Impressions  of  a 
Resident  Physician 

1883-1884 


Arthur  Ames  Bliss,  A.M.,  M.D. 


Printed  for  private  circulation 
MCMXVI 


/9/C 


Copyright,  1916, 
By  Laura  N.   Bliss. 


INTRODUCTION 

It  was  in  the  winter  of  1913,  that  my  husband  came  upon  his 
"Memoirs  of  Blockley."  He  decided  at  once  to  rewrite  and 
revise  them  for  publication.  Every  spare  moment  during  these 
winter  months,  in  spite  of  not  having  been  in  his  usual  health, 
Doctor  Bliss  spent  in  preparing  this  work.  It  seemed  to  give 
him  so  much  pleasure,  that  I  repressed  my  feelings  of  anxiety 
lest  he  might  overtax  his  strength. 

His  professional  duties  had  been  especially  hard  during  this 
winter,  and  he  gave  himself  unsparingly  to  the  many  who  called 
for  help.  These  "Memoirs"  had  been  just  finished  and  been 
typewritten,  when  God  called  him  to  his  Heavenly  reward. 

The  life  of  Doctor  Bliss  was  an  example  of  unselfish  devotion 
for  the  good  of  others,  and  of  rare  nobility  of  purpose. 

To  publish  these  pages  is  my  greatest  privilege. 

Laura  Neuhaus  Buss. 


PREFACE 

Humanity  has  been  observed  from  many  points  of  view. 
The  rich  and  great  and  fortunate  of  Earth  have  had  their  en- 
trances and  exits  on  the  stage  of  literature.  Great  authors  have 
told  of  the  lives  of  the  lowly  and  depraved.  Paradise  has  been 
described;  and  classic  writers  have  drawn  and  redrawn  the 
sunless  world  of  Hades  and  of  Purgatory.  Even  Hell  need  have 
few  surprises  for  any  one  who  reads. 

In  the  pages  of  this  little  book  there  is  a  candid,  almost 
photographic,  account  of  life  in  a  community  of  paupers,  where 
the  members  conduct  themselves  without  any  fear  that  fate  or 
the  authorities  can  put  them  in  a'hy  lower  place  than  that  in 
which  they  have  placed  themselves.  It  is  not  the  life  of  a 
reformatory  or  of  a  prison.  The  almshouse  is  merely  a  receptacle 
of  the  miserable  and  helpless,  and,  in  Blockley,  there  are  added 
hospitals  for  the  physically  and  mentally  ill. 

The  book  tells  something  of  the  life  and  habits  of  these 
submerged  citizens,  and  of  the  experiences  and  impressions 
gained  by  one  who  went  in  a.nd  out  very  freely  among  them 
in  the  peculiar  and  intimate  relations  of  a  resident  physician. 
It  is  a  plain,  direct  statement  of  things  that  actually  happened, 
without  any  attempt  to  enlarge  upon  them  or  to  soften  the 
blunt  realism.  And,  between  the  lines,  can  be  noted  the  effect 
of  this  life  and  contact  upon  the  journalist. 

It  is  a  grim  story,  not  without  some  touches  of  a  sad  humor. 
But  it  all  happened;  and  something  like  unto  it  has  been  worked 
into  the  life  of  many  a  resident  physician  not  alone  of  Old 
Blockley,  but  of  any  great  City  Hospital.  So  the  little  journal 
is  a  small  bit  of  actual  history. 

Arthur  Ames  Bliss. 
Philadelphia,  April  20th,  1913. 


Blockley  Days 


The  life  of  a  physician  who  has  pursued  his  calHng  within 
the  confines  and  surrounding  country  of  a  great  city  is  so  filled 
with  the  incidents  and  details  peculiar  to  his  profession,  that  he 
has  little  opportunity  to  review  his  career.  He  lives  so  entirely 
in  the  present,  that  there  are  no  spare  moments  in  which  to 
look  back  and  trace  for  footsteps  in  the  sands  of  time.  Such 
sands  are  shifting.  The  footprints  are  shallow  and  faint,  and 
little  would  be  gained  by  a  search  backward  through  the  forgotten 
years.  But  it  happens,  sometimes,  that  a  narrow  bit  of  trail 
may  have  survived,  and  certain  landmarks  remained  unchanged 
by  its  way.  There  came  a  chance  moment  in  the  busy  life  of 
a  doctor  now  advancing  into  middle  life,  when  the  need  for 
certain  notes  of  cases,  in  relation  to  a  study  of  an  obscure  disease, 
led  him  to  hunt  within  old  boxes  and  chests  in  a  lumber  room. 
The  reader  would  have  little  interest  in  all  that  such  delving 
amid  relics  revealed,  except,  perhaps,  for  the  discovery  of  one 
plainly  bound  notebook.  When  the  Doctor  unearthed  this 
small  volume,  a  flood  of  memories  seemed  to  spring  into  being, 
and,  for  a  moment,  he  was  floated  away  upon  a  tide  of  time 
that  set  him  somewhat  adrift  from  the  real  object  of  his  search. 
In  his  own  handwriting,  on  the  corner  of  this  book,  he  read 
the  title,  "Blockley  Days.  A  Journal,  September  1st,  1883 — 
August  31st,  1884.  'So  it's  over  the  hill  to  the  poorhouse.' " 
It  was  indeed  a  forgotten  trail;  and  the  discovery  of  the  foot- 
prints recalled  to  the  physician's  recollection  that  he  had  been 
an  interne  in  Blockley  Hospital,  and  that  he  had  essayed  to 
keep  a  sort  of  diary,  and  that  here  was  the  very  record  of  his 
good  or  evil  deeds  unexpectedly  facing  him  out  of  the  dusty 
corner  of  an  old  packing  box.     Blockley  has  undergone  such 


8 

changes  in  the  course  of  recent  years,  that  these  records  of  an 
official  life,  passed  there  almost  thirty  years  ago,  must  not 
be  applied  to  the  institution  as  it  exists  to-day.  The  diary 
has  some  historical  value,  as  it  describes  the  episodes  in  the 
life  of  a  resident  physician  of  that  period,  in  a  hospital  con- 
ducted much  on  the  general  lines  that  obtained  then  in  all 
large  city  hospitals.  But  the  inmates  of  that  day  might  be 
the  inmates  of  the  modernized  and  improved  institution  that 
succeeded  it;  for  human  nature  is  the  same  as  in  the  days 
of  Babylon.  The  tramp,  the  degenerate,  the  unfortunate, 
the  weakly  good  and  aggressively  bad  are  simply  clad  in  the 
rags  and  tatters  of  their  especial  time  and  place.  Blockley's 
guests  are  much  as  they  were  then  and  ever  have  been.  The 
administration,  the  methods  of  control  and  medical  attention 
have  revolutionized  the  place  so  greatly,  that  none  of  the  refer- 
ences in  this  diary  that  relate  to  nursing  and  hospital  details 
can  be  applied  to  the  institution  as  it  is  conducted  to-day. 
The  very  name  has  changed.  No  one  spoke  of  the  institution 
otherwise  than  as  Blockley.  This  name  of  reproach  is  now 
lost  in  the  modern  title  of  the  reformed  and  re-organized  insti- 
tution, "The  Philadelphia  General  Hospital."  The  Almshouse 
of  Philadelphia,  after  having  occupied  several  different  localities, 
was  finally  established  on  an  extensive  tract  of  farm  land  on  a 
narrow  lane  below  Spruce  Street,  bordered  on  the  east  by  34th 
Street,  and  extending  to  the  Philadelphia,  Wilmington  and 
Baltimore  Railroad  tracks  along  the  Schuylkill  River.  Its 
western  limit  was  another  picturesque  narrow  lane  which 
separated  it  from  a  bit  of  wooded  ravine  that  formed  a  part 
of  Woodlands  Cemetery.  In  old  times  all  this  district 
had  been  a  part  of  the  extensive  estate  of  Blockley,  and  thus 
the  large  community  of  City  Hospital,  Hospital  for  the 
Insane,  and  Almshouse  derived  the  name  by  which  it  was 
known,  and  to  which  a  certain  sinister  meaning  was  attached, 
on    account    of    the    maladministration    in    all    departments, 


and  the  general  misery  and  wretchedness  that  became 
a  part  of  the  lives  of  all  who  passed  within  its  gates. 
The  buildings  formed  a  vast  parallelogram  fiallowing  the  main 
lines  of  the  property  and  enclosing  a  large  central  courtyard. 
Through  the  centre  of  this  great  open  space  a  line  of  irregularly 
built  shops  and  storehouses  extended,  dividing  it  into  two 
great  halves  with  a  single,  dark,  gloomy  passageway  between, 
while  at  either  end  of  the  yard  arose  lofty  stone  walls,  with 
two  arched  gateways  and  heavy  gates  in  either  wall  for  com- 
munication with  the  great  north  and  south  halves  of  the  central 
open  courtyard.  Thus  divided,  the  northern  half  of  the  institu- 
tion was  for  the  accommodation  of  women,  and  the  southern 
half  for  men.  The  high  wall  to  the  eastward  separated  the 
yard  from  the  buildings  and  ground  of  the  City  Hospital,  while 
beyond  that  to  the  westward  were  the  extensive  buildings 
and  grounds  of  the  Asylum  for  the  Insane.  The  lines  of  build- 
ings between  these  eastern  and  western  divisions,  and  the 
great  court  itself,  formed  the  Almshouse  of  the  City  of  Phila- 
delphia. Thus  it  will  be  seen  that  the  Almshouse  dominated 
and  overshadowed  the  City  Hospital,  which  should  have  been 
free  from  the  associations  which  belong  to  this  home  for  the 
destitute  and  inefficient.  So  close,  however,  was  the  relation- 
ship of  the  various  departments  at  Blockley,  that  it  was  often 
with  extreme  difficulty  that  a  poor  but  respectable  man  or 
woman,  when  sick,  could  be  induced  to  enter  the  City  Hospital. 
"Oh,  Doctor!  Don't  send  me  to  the  Poorhouse!"  It  is  indeed 
a  shame  and  disgrace  that  a  hospital  which  should  have  been 
regarded  as  a  proper  and  honorable  place  of  retreat  for  the 
sick  poor  of  Philadelphia  should  have  been  so  burdened  by 
mismanagement  and  evil  associations  that  no  sick  man  or 
woman  sought  its  walls  willingly.  It  was  the  last  resort  for 
those  who  could  not  gain  admission  to  other  hospitals,  or  who 
were  absolutely  friendless  and  penniless. 

The  great  buildings  of  Blockley  were  of  uniform  construction. 


10 

having  mastic  covered  walls  of  a  dull  grey  color,  three  stories 
in  height,  with  a  low,  sloping  roof.  The  main  entrance,  facing 
towards  an  open  stretch  of  fields  that  represented  the  farm 
of  the  Almshouse,  was  a  rather  imposing  portico  of  Greek  design, 
standing  high  above  a  lower  story,  in  which  the  offices  of  the 
institution  were  housed.  One  gained  this  upper  terrace  by 
a  flight  of  steps,  passed  beneath  the  arcade  of  columns,  and 
entered  the  main  hallway,  on  one  side  of  which  the  Superin- 
tendent had  his  office,  while  a  door  on  the  other  side  led  to  the 
assembly  room  of  the  Board  of  Guardians  of  the  Poor,  the 
rulers  of  the  institution  and  the  various  activities  associated 
with  it. 

This  large  and  important  governing  board  consisted  of 
many  members  who  were  elected  to  their  office  by  the  City 
Councils.  Each  district  of  the  City  was  represented  among 
the  members  of  the  board.  For  many  years  it  had  been  con- 
nected with  the  less  open  and  honorable  field  of  local  politics. 
Few  citizens  of  sterling  character  or  important  standing  in 
the  community  cared  to  serve  in  its  ranks,  or  could  have  gained 
an  election  even  if  their  candidacy  had  been  proposed.  The 
board  had  a  bad  name.  Somewhat  caricaturing  its  manage- 
ment and  reputation  was  the  oft-heard  epithet  which  gave 
it  the  title,  "The  Board  of  Buzzards."  Among  the  earliest 
efforts  to  reconstruct  and  improve  the  City  was  a  determined 
effort  by  a  small  group  of  able  and  honest  members  of  the 
City  Council  to  elect  better  men  on  the  Board  of  Guardians 
of  the  Poor.  A  few  men  of  worth  and  prominence  in  the  social 
and  financial  affairs  of  the  City  were  persuaded  to  stand  as 
candidates  for  election.  It  was  a  hard  and  bitter  contest  in 
the  Councils,  but  the  better  elements  of  those  bodies  combined, 
and  filled  a  few  vacancies  on  the  Board  of  Guardians  with 
these  gentlemen  of  good  character.  Many  improvements  to 
the  institution  were  effected  by  the  work  of  these  new  members 
assisted   by   their   friends   in   the    City   Councils.     One   change 


11 

of  importance  was  the  appointment  of  resident  physicians  for 
Blockley  by  a  fairly  conducted  competitive  examination,  in  place 
of  the  old  system  of  appointment  through  personal  influence. 

It  was  a  dark,  sultry  day,  the  first  of  September,  1883, 
when  a  certain  young,  inexperienced,  and  somewhat  anxious 
youth,  who  had  gained  the  degree  of  Doctor  Medicinae,  and 
had  won  his  right  to  an  interneship  in  Blockley  by  the  first 
competitive  examination  held  for  this  position,  took  his  way 
over  the  Chestnut  Street  Bridge  across  the  Schuylkill  River 
and  turned  into  the  pleasant  shaded  lane  that  extended  in 
front  of  Blockley. 

The  farm  fields  sloped  gently  down  towards  the  river  from 
the  left  side  of  this  road.  The  trunks  of  the  trees  that  bordered 
the  lane  were  covered  with  whitewash.  The  sidewalk  was 
of  wood,  and  gave  such  a  hollow  reverberation  to  the  youth's 
feet,  that  there  arose  a  disturbing  notion  in  his  agitated  mind 
that  all  Blockley  must  hear  his  coming,  and  every  prospective 
patient  be  called  to  the  long  rows  of  windows  to  observe  his 
approach.  Far  away  over  the  river  was  a  nondescript  mass 
of  old  factories,  railroad  tracks  and  bridges,  and  the  green 
foliage  about  the  buildings  of  the  Naval  Asylum.  The  City 
had  a  sort  of  tag-end  appearance  from  this  view  of  its  more 
southern  portion.  A  break  in  the  long  line  of  grey  buildings 
was  closed  by  a  high  wall  through  which  was  a  wide-arched 
gateway.  Above  this,  in  black  letters  on  a  band  of  white,  was 
painted  the  title,  "Philadelphia  Hospital."  In  the  hospital 
ambulance  the  young  doctor  was  to  pass  in  and  out  of  that 
entrance  very  often  in  the  months  to  come,  at  all  hours  of  the 
day  and  night,  going  forth  for  or  bringing  back  paupers,  sick 
people,  and  sometimes  unfortunate  victims  of  mental  disease  in 
every  degree  of  delusional  wealth  or  misery. 

Knowing  nothing  of  what  lay  before  him,  the  young  medicus 
reverently  ascended  the  entrance  steps  as  to  the  shrine  of 
-^sculapius,  passed  beneath  the  somber  portals  of  Blockley,  and 


12 

became  one  of  the  denizens  of  that  strange  communit)'-  that, 
in  a  sort  of  microcosmos,  represented  the  misery  and  goodness, 
the  meanness,  the  brave  enduraiice,  the  cheap  -deceits,  the 
vileness  and  degradation  of  the  whole  great  world. 

It  is  surprising  how  quickly  one  finds  his  place  in  the  order 
and  discipline  of  life  in  a  great  hospital.  The  very  green  young 
doctor,  in  a  state  of  anxiety  and  mental  mix-up  as  to  his  ability 
to  meet  the  unknown  that  faced  him  in  the  wards,  who  doubted 
that  he  might  not  sin  from  ignorance  daily,  and  be  an  agent  of 
death  instead  of  health,  found  very  quickly  that  his  errors  were 
unknown,  unnoticed,  or  nonexistent.  The  faces  that  peer  out 
at  him  from  the  long  rows  of  beds  soon  cease  to  shock  him  with 
imagined  expressions  of  distrust,  contempt,  or  fear.  His  col- 
leagues of  the  resident  staff  give  him  friendly  hints  and  helpful 
suggestions.  The  grave  m.edical  or  surgical  chief  treats  him 
with  a  kind  consideration  that  combines  the  manner  of  a  father 
and  older  brother.  He  feels  the  unconscious  support  of  the 
great  organization  of  which  he  is  one  of  the  units,  a  soldier  in 
the  little  garrison.  The  events  of  each  day  confirm  him  more 
and  more  in  the  methods  of  thought  and  the  ethics  of  the  splendid 
guild  that  has  received  him  as  a  member,  and  to  which  his 
loyalty  and  enthusiastic  devotion  are  due  for  all  the  years  of 
his  life.  The  oath  of  Hippocrates,  seldom  pronounced  in  words, 
is  moulded  into  the  young  doctor's  habits  of  thought  by  the 
precept  and  example  of  his  associates.  For  truly  can  it  be  said, 
that  among  no  class  of  men  is  the  earnestness  of  their  calling 
more  expressed  in  their  lives  and  associations  with  one  another 
than  among  a  community  of  physicians.  There  is  a  wholesome 
boyishness  in  the  mental  make-up.  There  is  no  pretense  that 
they  are  models  of  piety.  In  the  great  army  to  which  they  belong 
are  deserters  and  camp  followers,  but  those  of  the  rank  and  file 
are  generally  true  to  the  responsibilities  of  their  great  trust. 
Like  Chaucer's  clerks  gladly  will  they  learn  and  gladly  teach. 
With  a  modest  acknowledgment  of  the  vastness  of  the  dark 


13 

unknown  about  them,  physicians  have  hopefully  looked  forward, 
through  all  the  ages,  for  more  light,  more  light.  In  a  time  when 
idealisms  are  dulled  in  the  greyness  of  a  materialistic  philosophy 
of  life,  it  is  still  the  physician  who  rejoices  to  spend  and  be 
spent  in  the  pursuit  of  scientific  truth,  who  values  his  life  cheaply 
in  the  struggle  with  ignorance  and  disease,  whose  compensa- 
tion is  more  often  found  within  his  conscience  than  in  bank 
cheques  or  coin  of  the  realm.  In  that  glorious  army  of  saints 
and  martyrs,  sung  by  the  Church;  those  who  have  borne 
testimony  to  their  faith  and  have  been  faithful  unto  death, 
there  are  few  physicians;  but  surely  another  group  of  martyrs, 
they  who  have  perished  in  the  struggle  against  error  and  the 
unknown,  who  have  lost  their  lives  in  the  conflict  to  tear  the 
veil  of  mystery  from  disease  and  let  in  the  sunlight  of  knowledge, 
the  unhaloed  army  of  martyrs  for  science,  should  have  their 
meed  of  praise. 

Without  any  direct  instruction  in  ethics,  the  young  medicus 
is  involved  in  a  social  order  that  honors  these  traditions  of  the 
past  and  the  heroes  from  the  history  of  his  profession.  Thus 
the  young  and  self-doubting  interne,  in  the  unconscious  influences 
of  his  surroundings,  as  well  as  the  direct  instruction  of  his 
colleagues,  begins  to  acquire  confidence  based  on  experience. 
The  medical  instinct,  that  specialized  combination  of  sense- 
perception  and  the  reasoning  faculties  in  relation  to  the  various 
phenomena  of  disease,  begins  its  development,  and  the  young 
medicus  finds  himself. 

The  Board  of  Guardians  possessed  a  City  office  building  on 
South  Seventh  Street.  It  was  an  old  and  dilapidated  dwelling 
house,  in  no  way  rebuilt  for  office  purposes,  but  simply  made 
available  by  the  most  limited  supply  of  desks  and  chairs  and 
benches  placed  in  parlor,  dining  room,  and  bedrooms.  In  what 
had  served  as  a  parlor,  on  the  ground  floor,  was  housed  the 
biu'eau  for  arranging  the  proper  payment  and  collection  of 
money  in  cases  of  illegitimate  children,  born  at  Blockley.     It 


14 

may  have  had  other  duties,  but  complaints  and  inquiries  in 
connection  with  the  consequences  of  infringement  of  the  seventh 
commandment  were  always  in  progress  on  the  occasions  of  my 
visits.  Above,  in  what  had  served  as  the  best  bedroom  in  days 
of  family  life,  the  "second  story  front,"  was  the  office  for  receiv- 
ing and  examining  applicants  for  the  Almshouse  itself  and  for 
the  hospital.  The  medical  examination  was  conducted  by 
a  Blockley  resident  physician.  One  of  our  staff  was  in  attendance 
daily,  for  a  few  hours  each  morning.  The  examination  in 
regard  to  social  conditions,  destitution,  and  inability  for  support 
was  made  by  the  Secretary  of  the  Board  of  Guardians  or  by 
the  House  Agent  of  Blockley.  It  must  be  confessed  that  the 
young  medical  man  was  too  often  disposed  to  be  sarcastic, 
cynical,  suspicious,  and  anxious  to  drive  away  every  applicant 
who  did  not  bear  in  his  or  her  body  the  symptoms  of  being  an 
interesting  medical  or  surgical  case.  On  the  other  hand,  the 
two  lay  officials,  men  long  trained  to  their  duties,  were  most 
patient  and  reasonably  sympathetic.  I  never  heard  either  of 
these  men  say  an  unkind  word  to  the  wretched,  broken  men  and 
women  who  applied  for  shelter  within  the  walls  of  Blockley. 
Not  infrequently  when  I  had  dismissed  an  applicant  with  a  con- 
temptuous statement  that  the  poor  man  or  woman  was  "not 
sick  enough"  to  be  admitted  to  the  hospital,  the  Secretary  or 
House  Agent,  whichever  one  happened  to  be  oJB&ciating  at  the 
desk,  would  find  some  excuse  for  admitting  the  subject  to  the 
Outwards — the  Almshouse  Department, — or  would  mildly  set 
aside  my  verdict  and  make  out  a  pass  for  the  hospital.  Having 
obtained  such  a  pass,  the  miserable  citizen  of  the  underworld 
would  start  on  the  long  journey  across  the  City  and  over  the 
Schuylkill  by  one  of  the  bridges  to  the  haven  of  rest  for  the 
poor  and  sick.  So  a  thin  stream  of  outcasts  took  its  way  daily, 
through  the  cold,  the  snow  or  melting  slush  of  winter,  or  the 
summer's  torrid  heat,  among  the  busy  shoppers  of  Market  or 
Chestnut  Street,  past  the  great  stores  and  amid  the  rushing 


IS 

traffic,  each  with  the  precious  bit  of  paper  that  meant  shelter 
and  somewhat  of  a  home.  Many  of  the  sick  must  have  spent 
long,  bitter  moments  on  the  way,  with  frequent  rests  on  door- 
steps or  against  raiUngs  or  on  the  curbstones  of  the  street.  It 
would  have  been  a  vision  for  an  artist  to  have  depicted  this 
long,  struggling  line,  as  wherever  in  this  sad  world  of  ours  the 
weary  and  heavy  laden  have  journeyed,  led  by  the  Man  of 
Sorrows,  with  His  patient  face  of  infinite  compassion,  bearing 
His  cross  and  going  on  before.  The  lowest  of  the  earth  are  in 
that  line,  outcasts  and  beggars  and  weaklings;  nothing  noble 
is  there,  nothing  heroic;  only  sickness  and  hunger  and  longing 
for  some  place  of  refuge. 

It  is  in  this  very  Seventh  Street  Office  that  the  scenes  of  the 
diary  have  their  beginning,  for  the  first  report  in  that  old  book 
is  entitled — 

"A  Gentleman  Gone  to  Seed. 

October  23,  1883. 

"At  the  Seventh  Street  Office,  a  few  days  ago,  I  came  across 
a  queer  example  of  whiskey-wreckage.  The  last  applicant  for 
admission  was  an  unsteady,  red-nosed,  dejected-faced,  white- 
haired  old  man  who  slunk  into  the  first  chair  near  the  door. 
I  asked  him  what  his  trouble  might  be  this  morning,  when  to 
my  surprise  he  answered  in  the  refined  tone  of  voice  of  an 
educated  Englishman.  He  wanted  shelter;  was  afflicted  with 
a  variety  of  complaints  all  of  which  narrowed  themselves  into 
the  syndromes  of  drunkenness  and  poverty.  During  the 
citations  of  what  he  was  and  what  he  wished  for,  he  quoted  from 
several  Latin  authors.  I  learned  that  he  was  a  graduate  from 
Eton,  that  he  had  taught  in  the  Cathedral  School  of  Exeter, 
and  that  he  had  been  a  teacher  in  this  country.  His  weakness 
for  drink  caused  him  to  lose  every  position  he  had  held,  and 
now  an  outcast  he  dragged  himself  from  the  gutter  and  begged 
for  admission  to  the  Almshouse.  We  decided  'to  send  him  out,' 
which  means,  he  obtained  his  pass  of  entrance.     The  Warden 


16 

took  pity  on  him  and  allowed  him  to  spend  the  days  in  his 
oiBce  doing  some  nominal  work,  for  the  old  fellow  is  lazy. 
Although  he  will  talk  for  hours  about  his  necessity  to  find  some 
occupation,  so  as  to  fill  his  mind  and  keep  out  sad  memories, 
still,  when  any  real  work  is  supplied,  he  seems  to  prefer  the 
memories.  He  is  a  real  old  Micawber.  A  few  days  ago  he 
told  me  in  a  most  independent  manner,  as  though  his  coming 
hither  had  been  a  matter  of  pure  option  on  his  part,  that,  'A 
few  more  days  will  decide  me  whether  to  remain  here  longer 
or  go  elsewhere.  My  mind  must  be  occupied.  I  find  it  very 
hard  to  put  up  with  the  profanity  of  this  place.  My  dear  sir! 
There  is  nothing  for  which  I  have  such  a  violent  aversion  as 
for  the  hoi  polloi!  I  wish  much  to  ask  you  a  question.  Can 
you  inform  me  as  to  the  necessary  steps  for  me  to  take  in  order 
to  obtain  a  piece  of  castile  soap?'  He  had  already  asked  me 
for  a  copy  of  Thucydides.  He  spends  much  of  his  time  in 
composing  ingenious  sentences  in  Greek  and  Latin  which  give 
the  same  meaning  when  read  backward  or  forward.  He  is 
the  saddest  object  on  earth,  a  gentleman  gone  to  the  devil. 
He  has  the  intellect,  sensitiveness,  and  the  exclusive  traits  of 
a  scholar,  and  yet  with  these  he  has  the  slavery  to  drink  which 
has  brought  him  to  the  level  of  its  other  victims  here,  most  of 
whom  are  of  the  opposite  social  scale  to  which  he  belongs.  What 
a  place  of  decay  and  death  this  is!  It  reminds  me  of  the  Ox 
Bow  in  the  Connecticut  River.  The  broad,  deep  river  flows 
on,  but  into  this  back  stream  drift  the  deadwood,  scum,  withered 
leaves,  floating  corruption;  and  there  they  drift  together  swirl- 
ing around  in  the  sluggish  current,  sinking  to  its  muddy,  oozy 
bottom,  never  again  floating  out  into  the  open  stream.  Hope 
gone!  Ambition  gone!  Yes,  the  very  sense  of  shame  van- 
ished!" 

"Arrogant  Guests. 

October  24,  1883. 
"What  I  am  unable  to  understand,   or  rather  what  con- 


17 

stantly  surprises  me,  is  the  degree  of  arrogance  which  the 
inmates  of  this  place  develop  during  their  sojourn.  I  have  seen 
men  who  have  come  here  as  a  last  resort,  actually  picked  up 
out  of  the  streets,  who  after  a  few  weeks'  stay  develop  all  the 
selfishness  and  overbearing  manners  of  one  born  to  every  luxury 
that  wealth  supplies.  They  order  the  nurses  about  as  one 
might  speak  to  slaves.  They  complain  of  the  slightest  dis- 
comfort. They  anathematize  the  food  and  cooking,  both  of 
which  are  far  superior  to  any  they  have  known  for  years.  The 
only  individual  of  whom  they  stand  in  awe  is  the  doctor,  for 
he  has  the  keys  of  a  heaven  or  hell,  and  can  allow  them  to  rest 
in  sheltered  ease  or  send  them  forth  to  experience  winter  and 
cold  weather  in  the  streets.  And  I  must  confess  that  it  is 
almost  a  pleasure  to  me  to  'come  down  heavily'  on  such  men 
as  these.     In  some  cases  there  must  be  a  limit  to  long-suffering." 

"Cadaverous  Charue. 

October  31,  1883. 
"There  is  a  man  here  named  Charlie.  He  has  charge  of 
the  green-room  or  green-house,  both  of  which  are  the  local 
terms  for  the  post-mortem  laboratory,  or  dead-house.  Charlie's 
entire  time  is  devoted  to  work  upon  the  dead.  He  is  present 
at  the  autopsies,  sews  up  the  incisions  after  examinations,  and 
takes  measures  to  preserve  in  glass  the  various  specimens  which 
are  to  be  kept  in  a  sort  of  alcoholic  immortality.  He  is  a  well- 
built,  broad-shouldered,  and  cheerful-tempered  German,  and 
is  quite  an  anatomist.  He  never  estimates  a  man,  either  living 
or  dead,  by  his  face  or  reputation,  but  judges  of  his  worth  by 
considering  w^hat  kind  of  a  skeleton  he  would  make,  if  the 
fortunate  opportunit}^  offered.  A  stranger  at  once  excites  his 
notice,  and  he  exclaims,  'Mein  Gott!  Vhat  a  vine  skeleton  dat 
man  vould  make!'  Or,  it  may  be  that  the  whole  ensemble  was 
below  standard,  and  that  the  skeleton  would  be  a  frank  failure 
and  unsatisfactory.     He  has  fitted  up  a  neatly  made  bracket 


18 

on  one  v,^all  of  the  post-mortem  room,  and  here  the  severed 
head  of  an  insane  negro  rests,  which  Charlie  had  embalmed 
and  prepared  with  tender  care.  In  its  way  it  is  a  work  of  art. 
The  ghastly  ornament  has  painted  eyes,  made  from  paper  and 
fitted  between  the  eyelids,  giving  quite  a  satisfied  and  friendh^ 
expression  to  the  face.  A  pair  of  femurs  are  crossed  behind 
the  head,  and  the  whole  makes  a  most  horrible  ornament  for 
this  place  of  death,  but  evidently  brings  much  satisfaction  to 
the  cadaverous  mind  of  Charlie. 

"v.  has  gone  off  in  the  ambulance  to-night  to  bring  back  an 
insane  woman  to  the  hospital.  I  was  to  have  gone  also,  but,  as 
Donovan's  arm  was  amputated  to-day,  the  Warden  thought 
it  best  that  I  should  be  on  hand  in  case  of  trouble.  So  M.  has 
gone  in  my  place.  They  will  have  a  rather  moving  experience, 
as  the  woman  is  so  violent  that  her  husband  dares  not  enter 
the  house." 

It  would  be  difficult  to-day  for  any  one  to  conceive  of  hospital 
work  without  the  efl&cient  services  of  the  trained  nurse.  Every 
institution  has  its  school  for  nurses,  in  which  young  women  of 
good  character  and  a  very  fair  degree  of  general  education  are 
instructed,  employed  in  the  service  of  the  hospital,  and  grad- 
uated after  having  pursued  the  full  course  and  passed  the  pre- 
scribed examinations.  So  valuable  and  essential  are  the  services 
of  these  nurses  that  no  satisfactory  result  in  medicine  or  surgery 
could  be  obtained  without  their  aid. 

The  Blockley  of  1883  had  no  trained  nurses.  Each  depart- 
ment had  an  official  called  the  Head  Nurse.  These  officers 
were  men  or  women  appointed  by  the  Board  of  Guardians  and, 
in  most  cases,  prot^g^s  of  some  one  member  of  that  board. 
Their  skill  in  the  art  of  nursing  was  not  so  much  considered  as 
the  influences  that  placed  them  for  nomination  and  their  ability 
to  keep  order  in  their  departments  after  appointment.  The 
acting  nurses  for  all  wards  were  simply  convalescent  patients 


19 

who  evinced  some  aptitude  in  carrying  out  orders,  and  who 
received  a  small  compensation  in  money  for  their  imperfectly 
done  work.  Among  such  convalescents  there  would  develop, 
from  time  to  time,  some  man  or  woman  who  seemed  to  have 
a  natural  instinct  for  the  required  work,  and  who  dreaded  a 
plunge  again  out  into  the  world  beyond  the  high  walls.  Per- 
haps without  any  valuable  friends  and  with  little  ambition, 
such  individuals  had  acquired  a  species  of  "Blockley  habit,"  and, 
until  they  wearied  of  the  place  and  work,  were  content  to  live 
on  and  labor  in  its  wards  for  mere  bed  and  board  and  a  nominal 
wage.  Among  such  as  these  were  found  the  assistants  to  the 
Head  Nurses,  sometimes  rising  even  to  the  dignity  of  night 
nurses. 

It  was  a  strange,  irregular,  untrained  force,  the  members 
of  which  not  infrequently  fell  from  grace  by  returning  drunk 
after  a  day  off  in  the  City,  or  who  wandered  back  to  their  old 
associations  and  ways  of  life.  In  the  office  we  had  a  very 
intelligent  gentleman  who  had  been  a  volunteer  clerk  for  several 
years,  because  within  the  walls  he  was  able  to  remain  sober, 
but,  once  outside,  would  mean  drink,  drunkenness,  and  delirium 
tremens.  Of  course  our  main  officials,  the  Superintendent, 
Chief  Clerks,  and  members  of  the  administrative  staff,  were 
men  of  character  and  efficiency. 

Among  our  comparatively  untrained  head  nurses  were  men 
and  women  of  fine  instincts  and  good  judgment.  Although 
most  of  them  belonged  to  a  class  of  individuals  fitted  for  domestic 
service  rather  than  for  the  management  of  hospital  wards, 
we  had  some  who  won  and  held  the  affection  and  respect  of 
every  resident  physician  of  that  day  and  generation.  Mr. 
Smith,  the  white-haired,  clean-shaven,  and  fine-featured  old 
man  who  was  chief  nurse  of  one  of  the  departments  of  the 
surgical  wards  for  men,  was  a  splendid  character.  This  really 
fine  old  gentleman  would  receive  the  wild,  raw,  young  internes, 
in  his  neatl}--  kept  office,  with  an  air  of  kindly  deference  and 


20 

quiet  dignity  that  commanded  respect.  Doubtless  his  long 
experience  in  practical  work  had  given  him  a  better  knowledge 
of  the  needs  of  our  patients  than  the  interne  had  gained  from 
his  college  training.  Everybody  loved  Nurse  Owens,  the 
amiable,  patient,  and  cheery  head  nurse  of  the  medical  wards 
for  men.  A  rather  fiery  and  energetic  character,  well  fitted 
to  be  first  mate  on  a  sailing  clipper,  ruled  the  surgical  wards 
for  men.  He  had  lost  one  leg,  and  the  slightest  disturbance 
in  any  of  those  wards  would  be  attended  by  a  rapid  and  energetic 
stumping  through  the  corridors,  as  the  leg  and  stump  came 
swinging  in  hurried  rhythm,  and  rebellion  was  hushed  by  a 
quick  sharp  command.  There  was  an  impression  given  that 
all  our  hospital  officials  had  been  through  more  or  less  interesting 
history,  that  there  were  backgrounds  in  their  lives.  The  women 
nurses  were  not  so  able  or  of  such  decided  character  as  were 
the  men;  and  yet,  considering  the  methods  of  appointment 
and  the  imperfect  training  for  the  responsible  positions,  it 
is  much  to  be  wondered  at  that  the  general  work  and  the  order 
of  the  wards  were  so  well  maintained.  This  absence  of  trained 
nurses  threw  much  more  responsibility  upon  the  internes  than 
is  now  the  case  in  any  hospital.  We  did  all  the  surgical  dressings, 
and  were  forced  to  oversee  very  closely  the  details  of  the  nursing 
itself.  Of  course  there  must  have  been  terrible  negligence 
and  oversight.  During  the  long  hours  of  night  duty  there  was 
no  one  to  superintend  the  work  of  the  untrained,  unintelligent, 
and  far  from  zealous  workers.  The  books  for  night  orders 
might  be  most  carefully  written  by  the  interne,  with  dosage 
and  hours  detailed  for  medicine  and  feeding,  yet  who  could 
tell  that  the  attendants  did  not  eat  the  food  and  drink  the 
stimulants  themselves?  The  patients  may  possibly  have 
received  the  medicine.  It  was  a  time  when  much  reliance  was 
placed  upon  alcohol,  in  all  exhausting  fevers.  Our  patients 
were  of  a  class  that  knew  whiskey  and  valued  it  highly.  They 
were  apt  to  know  when  it  was  ordered  for  the  night,  and  their 


21 

insistence  on  receiving  their  doses,  and  fear  that  they  would 
report  to  the  doctor  any  failure  in  this  attention,  probably 
deterred  the  night  attendants  from  consuming  all  the  supply 
that  was  ordered  for  distribution.  But  the  patients  recovered 
in  very  fair  proportion,  and  it  must  be  acknowledged  that 
the  rank  and  file  of  our  poorly  trained  helpers  took  interest 
and  even  pride  in  their  share  of  credit  for  the  good  results. 

"A  Martinet. 

November  13,  1883. 
"Nurse  H.  is  a  remarkable  character.  He  ought  to  have 
command  of  a  crew  of  pirates.  His  abilities  are  really  lost 
in  this  relatively  law  abiding  community.  He  is  of  large  size, 
possesses  the  strength  and  gentleness  of  a  blacksmith,  and, 
although  thoroughly  good-hearted,  is  obsessed  with  the  idea 
that  all  patients  are  prisoners  and  are  to  be  treated  accordingly. 
Conscientiously  faithful  in  dut}^,  he  believes  in  maintaining 
a  high  ideal  of  dignity.  I  am  sure  that  he  is  annoyed  that  I 
do  not  assert  myself  as  Allah,  and  then  he  could  figure  as  my 
prophet.  When  I  appear  at  the  door  of  the  ward,  Nurse  H. 
always  stops  his  work,  strides  to  the  middle  of  the  room,  glares 
about  him  with  an  expression  of  great  threatening,  and  calls 
out  in  a  powerful  voice, — 'Silence.  The  Doctor's  in  the  ward!' 
This  is  a  nice  direct  way  of  giving  a  timid  medicus  a  due  sense 
of  his  importance.  To-day  he  interspersed  strictly  professional 
notes  with  accounts  of  our  patients'  misdoings.  'Bed  No.  5 
over  there's  been  at  it  again;  hidin'  chunks  of  steak  under 
his  mattress  and  eatin'  of  'em  at  night.  Bed  No.  lO's  took  off 
his  dressin's.  Bed  14  tried  to  rub  his  wound  sore.'  This 
latter  performance  is  not  infrequent  when  a  convalescent  patient 
fears  that  his  recovery  means  a  few  days  of  work  or  immediate 
discharge  from  the  hospital." 

In  the  days  of  the  diary  surgical  cleanliness  or  antisepsis 
was   unknown.     The   operating  room   was  the   wooden-floored 


22 

arena  of  the  great  lecture  amphitheatre.  The  operating  table 
was  of  wood.  The  entire  furnishings  of  this  great  room  were 
of  the  same  material.  No  sterilization  of  instruments  or  dress- 
ings was  attempted.  The  surgeons  and  all  the  assistants  wore 
their  ordinary  street  or  house  costume.  The  residents  were 
clad  in  their  uniforms  of  blue  and  brass  and  gold  bands  and 
stars,  which  were  supposed  to  be  a  copy  of  the  uniform  of  a 
surgeon  in  the  Navy  of  the  United  States.  Usually,  one  suit 
of  uniform  sufficed  for  the  entire  year  of  service,  so  that  it  was 
far  from  surgically  clean.  If  an  instrument  chanced  to  fall 
on  the  wooden  floor,  it  might  be  quickly  wiped  with  an  ordinary 
towel  and  immediately  put  to  further  use.  The  dressings 
were  of  an  ancient  system  of  surgery,  bearing  no  resemblance 
to  those  in  use  to-day.  One  of  the  visiting  staff  who  had  just 
returned  from  London,  where  he  had  seen  something  of  the 
work  of  the  great  Lister  and  his  assistants,  attempted  an  imita- 
tion of  the  rather  complicated  dressings  used  by  that  great 
man,  but  his  colleagues  smiled  forbearingly  and  continued  the 
old  wet  and  open  treatment  and  had  a  horror  of  a  dry  wound. 
Nothing  healed  by  first  intention  unless  the  intention  of  the 
operator  was  thwarted  by  a  kind  providence,  and  good  luck 
won  in  spite  of  our  efforts.  Strange  as  it  may  seem,  however, 
most  of  our  cases  recovered  after  a  long,  slow  process  of  healing. 
The  operative  work  was  of  a  simple  character,  as  the  wonders 
of  modern  surgery  could  not  have  been  dreamed  of  under  the 
methods  in  vogue  in  those  days.  The  most  important  public 
clinics  were  held  on  Saturday  morning,  and  the  medical  and 
surgical  chiefs  selected  their  cases  for  demonstration  with 
reference  to  that  great  day.  There  is  a  reference  made  to 
such  a  clinic  under  a  note  in  the  diary  entitled 

"Anderson,  the  Bum. 

November  19,  1883. 
"'This,'  said  Nurse  H.  stopping  before  a  cot  on  which  a 


23 

new  patient  lay,  'is  Anderson,  the  Bum.'  Anderson,  surnamed 
the  Bum,  opened  his  grey  eyes  and  looked  at  Nurse  H.  with  a 
glance  plainly  indicating  malice,  but  which  changed  almost 
immediately  to  a  look  of  lazy  indifference.  Upon  the  face  of 
Mr.  Anderson,  life  had  clearly  printed  the  hieroglyphics  of 
laziness,  courage,  humor,  and  cruelty.  It  was  battered,  weather- 
beaten,  and  seamed  with  ugly  scars;  and  yet  the  head  was 
well-shaped,  with  a  broad,  almost  intellectual  forehead.  There 
was  a  strange  mingling  of  gentlemanly  refinement  and  brute 
coarseness.  The  man's  figure  was  massive,  with  broad  shoulders, 
large  chest,  and  good  length  of  limbs.  Anderson's  advent 
in  the  ward  occurred  several  days  ago,  and  I  have  had  an  oppor- 
tunity to  develop  considerable  interest  in  the  man  socially  as 
well  as  professionally.  He  has  been  an  inmate  of  the  ward 
before,  and  is  well  known  to  several  of  our  other  guests,  whose 
glee  was  manifest,  as  they  anticipated  that  the  ennui  of  the 
ward  was  to  be  relieved  by  the  appearance  of  this  jolly  devil. 
As  our  newly  arrived  bum,  however,  has  an  abscess  of  the 
liver,  and  is  in  a  very  weak  condition,  his  social  qualities  will 
not  appear  to  their  best  advantage  and  add  happiness  to  the 
ward.  Dr.  P.,  our  chief  surgeon,  selected  him  as  a  case  for 
operation  at  to-day's  clinic.  As  Anderson  watched  me  yesterday 
in  my  attempts  to  adjust  his  mattress,  so  as  to  make  him  less 
uncomfortable,  he  remarked  in  his  slow,  lazy  voice,  'Say,  Doctor! 
You're  taking  a  deal  of  trouble  for  nothing.  I  don't  feel  a 
bit  grateful  for  it  all;  and  say,  you  know,  I'd  a  deal  rather 
be  let  alone!'  I  told  him,  in  reply,  that  the  expression  of  grati- 
tude would  be  so  entirely  beyond  the  line  of  our  hospital 
experience,  that  its  exhibit  would  come  almost  as  an  unpleasant 
surprise. 

"The  man  must  have  an  interesting  background.  I  can 
learn  absolutely  nothing  about  him,  except  that  he  has  been 
an  inmate  of  this  hospital  on  several  occasions,  when  he  has 
made  considerable  trouble  in  the  ward. 


24 

"He  was  wheeled  into  the  operating  room  this  morning. 
In  the  great  amphitheatre,  the  circling  rows  of  seats  were  crowded 
with  students,  tier  above  tier,  until,  to  one  standing  down  in 
the  deep  arena,  the  very  air  above  seemed  filled  with  eager 
faces.  The  patient  lay  on  a  high,  revolving,  wooden  table 
in  the  centre  of  the  arena,  and  was  clearly  displayed  in  the 
light  which  streamed  from  the  skylight  in  the  lofty  roof.  Close 
by  stood  Dr.  P.,  knife  in  hand,  lecturing  to  the  students  in 
his  rather  stagely  manner.  On  either  side,  each  in  his  proper 
place,  were  grouped  the  resident  physicians.  I  face  Dr.  P. 
on  the  opposite  side  of  Anderson,  as  the  chief  assistant,  and 
in  the  background  stand  a  few  nurses.  Everything  is  calm, 
S3^stematic,  almost  druidical.  There  is  a  breathless  hush  and 
the  light,  sweet,  sickening  odor  of  ether  fills  the  air.  'Gentle- 
men, the  next  case  which  we  now  bring  before  you,'  says  Dr.  P., 
'I  have  explained  alread}?-,  and  the  operation  will  now  proceed.' 

"Well,  so  it  is  here  on  the  clinic  day!  But  the  students 
vanish.  Dr.  P.  goes  home,  or  to  patients,  or  to  another  operation, 
or  to  the  opera,  or  to  a  banquet,  and  we  poor  devils  are  left  to 
fight  out  the  after-treatment,  which  is  a  good  deal  more  of  a 
work  than  the  drama  of  the  knife." 

"The  Story  of  a  Night  Watch. 

November  27,  1883. 
"Edmunds  was  operated  upon  last  Saturday  for  excision  of 
the  right  hip  joint.  He  is  a  strange  combination  of  meanness, 
wickedness,  low  cunning,  and  moral  cussedness  inherited  or 
acquired.  Plis  father  was  a  criminal;  his  mother  not  much 
better.  He  has  been  in  two  different  prisons  for  long  terms 
of  confinement.  The  unfortunate  being  certainly  has  suffered 
horribly,  and  would  arouse  every  one's  sympathy  did  he  not 
also  call  up  feelings  of  utter  disgust  for  his  character.  His 
last  day  on  earth  came  very  near  to  being  that  of  the  operation. 
It  was  in  the  clinic  room.     We  commxcnced  at  about  half  after 


25 

eleven  o'clock.  It  was  almost  four  in  the  afternoon  before  he 
was  placed  and  finally  fixed  in  Bruce's  splint.  Dr.  P.  thought 
that  he  was  dying,  but  we  managed  to  move  him  into  an  empty 
ward  and  there,  after  long  working  with  whiskey,  ammonia, 
strychnia,  and,  later,  beef  tea  and  milk,  he  was  at  last  brought 
into  a  sort  of  working  order.  I  spent  the  night  with  him,  as 
it  was  out  of  the  question  to  trust  to  the  tender  mercies  of  a 
mere  watchman.  j 

"It  was  a  strange  and  long  to  be  remembered  night.  I  | 
had  been  busy  in  the  ward  from  half  after  eight  o'clock  that  ! 
morning,  and  had  failed  to  get  any  dinner  on  account  of  the 
unusually  long  clinic.  Edmunds  had  been  moved  into  a  large,  ! 
barren,  square  room  with  board  walls  without  plaster  and 
worn  or  stained  to  a  dark  mahogany  color.  My  patient,  propped 
up  with  pillows,  lay  on  the  operating  table  from  which  he  had  \ 
been  too  weak  to  be  removed.  Above  his  head,  high  up,  a 
single  gas  jet  threw  down  a  feeble  light  on  his  pale,  emaciated, 
pain-marked  face.  A  storm  had  arisen,  and  all  night  the  wind 
moaned  about  the  buildings,  rattling  the  window  sashes  with 
sudden  gusts.  There  was  a  bright  fire  in  the  stove,  the  only 
cheerful  object  in  the  room.  Around  the  walls  and  placed 
above  spaces  once  occupied  by  beds,  were  many  tin  frames 
containing  cards  which  noted  the  bed  numbers  and  the  names, 
ages,  and  diseases  of  patients  who  had  long  since  gone  back  to 
life  and  work,  or  perhaps,  instead,  to  the  Potter's  Field  or 
dissecting  table.  They  looked  to  me  like  memorial  tablets, 
raised  to  the  departed.  The  ward  had  been  unused  for  some 
time,  and  numerous  rats  had  established  a  colony  in  its  walls. 
Here  I  sat  until  almost  four  o'clock  in  the  morning.  Slowly 
the  hours  passed  by,  marked  by  the  solemn  tones  f  the  hospital 
clock.  Edmunds  would  awaken  occasionally  from  a  troubled 
sleep,  groan,  make  some  incoherent  exclamation,  take  what 
was  administered,  and  again  drop  off  into  a  semi-conscious 
state.     Otherwise,  everything  was  very  still,  except  when  the 


26 

wind  blew  in  gusts  against  the  windows,  or  the  rats  scuttled 
about  in  the  walls  or  flooring  or  squeaked  in  the  wainscoting. 
Suddenly  came  a  visit  strange  and  unexpected.  It  must  have 
been  near  midnight.  Edmunds  had  been  restless  but  was 
sleeping  quietly.  I  sat  before  the  fire  thinking  of  the  room's 
history.  How  much  pain  and  agony  those  walls  had  enclosed! 
How  much  suffering  each  poor  wretch  drifted  hither  on  the 
tide  of  life  represented,  even  outside  and  beyond  himself,  the 
suffering  he  had  caused  to  and  received  from  others.  A  sound 
seemed  to  creep  into  my  train  of  thinking;  a  sound  distinct  and 
real,  yet  vague  and  far  away;  a  rushing,  whirling  sound  as  of 
something  flying,  hastening  on  rapid  feet  that  caused  no  footfall 
but  the  rush  and  gliding  shadow  of  a  sound.  The  door  of  the 
deserted  ward  opened  into  a  long,  dark  entry.  Into  the  upper 
end  of  this  passage  the  sound  seemed  to  enter.  It  was  louder 
now  and  growing  nearer,  the  pattering  of  hurrying  feet  that 
scarcely  seemed  to  touch  the  floor.  Suddenly  a  piercing  shriek 
arose,  loud,  wild,  and  full  of  utter  woe,  a  shriek  that  seemed  to 
embody  the  suffering  of  a  lifetime  and  of  an  eternity  beyond. 
The  cry  rang  out  shrill  and  clear,  and  a  something  fell  violently 
against  my  door.  Then  the  night  was  still  again.  Edmunds 
had  not  awakened,  so  I  went  to  the  door,  opened  it,  and  beheld 
in  the  thick  darkness  of  the  entry,  as  it  were  sunken  in  the 
darkness  itself,  two  glaring,  fiery  eyes.  Edmunds  had  frequently 
remarked  to  me,  that,  when  his  time  came  to  be  carried  to  the 
dead  house,  whither  he  had  seen  so  many  borne  during  his 
long  illness,  that  the  Devil  would  at  once  take  his  soul  to  the 
underworld  or  shadows.  Had  the  Evil  One  come  to  claim 
his  own?  I  threw  a  piece  of  coal  at  the  Evil  One  and  the  fiery 
eyes  vanished ;  but  a  light,  galloping  sound,  as  of  a  cat  in  extreme 
haste,  was  apparent  and  grew  fainter  into  the  remote  distance. 
I  closed  the  door  and  sat  down  again  by  the  fire,  but  I  was 
soon  conscious  that  something  was  in  the  room  that  had  not 
been  there  before.     Seated  by  the  stove  and  looking  up  into 


27 

my  face  was  a  small  grey  and  black  streaked  cat.  Evidently 
it  had  been  in  company  with  that  evil  thing  which  had  flown 
away  up  the  entry.  With  me  it  was  in  better  company,  and 
I  was  glad  to  have  its  society  for  the  rest  of  the  dreary  night. 
At  one  o'clock  in  the  morning  a  watchman  arrived  with  my 
lunch,  which  consisted  of  a  very  large  bowl  of  coffee,  Irish  stew, 
and  bread  and  butter.  The  cat  and  I  agreed  that  it  was  a 
pretty  good  lunch  and  timely.  At  length  half  after  three 
o'clock  was  reached,  and  the  watchman  whom  I  had  chosen 
put  in  an  appearance.  It  was  sweet  to  get  to  bed;  but  oh, 
how  short  and  sweet!  For  soon  vSam's  horrible  voice  announced 
at  the  door,  'Half  past  seven,  Doctors;  half  past  seven;  half 
past!'     The  work  of  another  day  was  begun." 

"By  the  Way. 

December  2,  1883. 
"V.  has  departed  homeward,  having  received  a  letter  that 
gave  news  of  his  father's  sickness.  The  attack  seems  to  be  a 
severe  one  of  quinsy,  and  my  energetic  roommate  has  hastened 
home  with  his  mind  filled  with  ideas  to  meet  any  eventuality, 
I  thought  that  he  had  discovered  every  possible  method  of 
treatment  needed  for  any  complication,  but  I  came  upon  him 
suddenly,  at  the  last  moment  when  he  should  have  been  well 
on  his  way  to  the  railroad  station,  reading  up  the  subject  of 
Feeding  by  the  Rectum.  The  medical  talent  of  the  town  will 
be  startled  when  Dr.  V.  comes  on  the  scene  in  his  present  state 
of  mind,  and  with  the  armamentarium  that  he  is  prepared  to 
set  into  action.  To-day  was  Sunday,  a  busy  one,  and  as  little 
like  my  old-time  Sundays  as  day  is  like  night.  Sunday  has 
been  a  variable  day  in  my  experience.  The  time  has  not  long 
passed  since  it  was  the  cloud  and  bugbear  of  my  infant  life. 
Dreaded  from  one  week's  end  to  the  next,  the  fact  of  its  existence 
and  regular  coming  hung  like  a  pall  over  my  youthful  hilarity. 
The  day  became  less  trying  as  years  advanced.     To  be  sure,  I 


28 

had  to  read  'Barnes'  Notes,'  on  Sunday  afternoons,  and  the 
Notes  of  Barnes  and  those  Sunday  afternoons  were  painfully 
long.  But  then,  barring  Barnes  and  his  Notes,  the  day  was 
not  wholly  unpleasant,  for  it  was  judged  that  I  could  go  out- 
side the  door  of  the  house  into  the  open  and  yet  not  sin.  At 
Princeton  the  day  was  the  pleasantest  one  of  the  week.  It 
was  after  the  long  walks  of  Saturday  afternoon.  We  had  no 
w^ork,  and  we  did  have  a  fair  dinner,  followed  by  a  supper  rather 
more  choice  than  usual.  During  medical  student  days  the 
great  day  became  truly  a  Godsend,  for  it  brought  the  only 
rest  of  mind  afforded  an  overworked  candidate  for  the  degree. 
During  its  passage  we  could  throw  physics  to  the  dogs  and 
have  some  freedom  of  thought  and  action.  And  now  the 
busy  life  here  reduces  the  day  to  the  standard  of  work  required 
for  all  other  days.  But  there  is  yet  a  difference,  though  I  know 
not  what  it  is.  Something  in  the  air,  in  the  sky,  in  all  instincts 
and  memories,  unconsciously  and  subconsciously  at  work, 
announces  that  this  is  Sunday;  and  from  far  away  beyond  the 
walls  of  the  Almshouse  comes  the  sound  of  ringing  bells." 

"Work  in  the  Dead  House. 

December  10,  1883. 
"Edmunds  died  last  Tuesday.  An  autopsy  was  held  on 
his  body  last  Thursday  afternoon.  I  did  the  cutting.  Dr.  P. 
had  sent  out  word  that  he  wished  the  entire  pelvis  and  the 
diseased  femur  removed  and  sent  to  him  for  his  college  museum. 
So,  after  the  post,  I  commenced  the  operation  of  excision  of 
the  pelvis.  It  is  quite  an  undertaking,  and  the  day  was  well 
advanced  into  the  late  afternoon.  Daylight  is  short  now. 
There  is  no  means  of  lighting  the  dead  house  except  by  candle 
or  lantern.  Finally  Dutch  Charlie,  the  last  helper  available, 
went  oft"  to  his  supper  and  I  was  left  alone.  At  the  upper  end 
of  the  long  table  lay  all  the  recognizable  parts  of  my  former 
patient.     His  face,  deeply  marked  with  lines  of  pain,  was  quiet 


29 

with  the  rest  which  had  come  at  last.  His  eyes,  wide  open, 
had  the  far-away  blank  gaze  of  death.  It  is  an  indescril^able 
stare,  as  though  the  dead  man  saw  far  off  something  for  which 
he  had  long  been  searching,  and  was  satisfied.  And  in  the 
face  of  this  poor  crime-possessed  pauper  there  was  a  touch,  a 
shade  of  expression,  which  seemed  reflected  from  some  former 
time  when  he  was  a  child  and  innocent.  I  could  see  this,  because 
I  had  worked  over  him  and  watched  so  long.  Yet  one  who 
had  been  present  that  afternoon  had  exclaimed, — 'What  a 
villainous  face!'  What  would  he  have  said  if  he  had  seen 
Edmunds  at  his  worst!  It  was  getting  dark.  I  could  hardly 
see  to  place  my  knife.  In  one  corner  of  the  room,  leaning 
against  the  wall,  was  a  roughly  made,  unplaned  cofnn  with 
shavings  for  a  pillow.  In  this  the  mangled  remains  of  what 
had  been  humanity  was  to  be  carried  to  the  Pit  or  Potter's 
Field,  and  there  hidden  away  under  the  ground. 

"Along  the  walls  of  the  room  on  shelves  were  large  glass 
jars  containing  impossible  babies  or  specimens  of  various  organs 
gone  wrong  by  disease,  and,  from  a  nail  fastened  into  the  side 
of  a  grey-painted,  greasy  cupboard,  hung  a  dangling  mass  of 
leather  and  metal  charms,  tarnished,  stained  with  filth  and 
wear,  that  had  been  taken  from  many  bodies  posted  in  this 
clearing  house.  I  say  clearing  house  advisedly,  because  here 
the  truth  comes  to  light.  A  learned  professor  may  have 
diagnosed  a  disease  while  the  patient  was  still  under  treatment. 
He  may  lecture  learnedly  and  eloquently  upon  his  diagnosis 
to  crowds  of  wondering  and  note-taking  students;  yet  the 
observations  held  in  this  room  may  prove  that  the  professor's 
bad  organs  were  good  organs,  and  that  the  good  were  all  bad, 
and  that  there  was  no  more  health  in  the  diagnosis  than  in  the 
patient.  Through  an  open  door  that  admitted  to  an  outer 
room,  placed  on  rudely  made  trestles,  could  dimly  be  seen  a 
row  of  coffins,  many  of  which  were  already  filled  while  others 
were  3''et  v/aiting  for  their  occupants.     Such  is  the  dead  house. 


r 


30 

and  here  I  labored  in  the  moonhght  aided  by  two  candles,  until 
the  unpleasant  work  was  finished.  Then  Charlie  arrived 
with  additional  candles,  in  time  to  place  the  removed  bones 
in  water  and  clear  the  debris.  I  had  intentionally  left  the 
body  in  such  a  condition  that  the  parts  could  have  been  replaced, 
skin  and  flaps  sewed  up,  and  the  whole  would  not  have  presented 
svTch  a  very  bad  appearance.  But  there  was  no  need  of  this 
care  for  Edmunds'  clay;  his  friends  long  ago  lost  to  him;  his 
family,  criminals  themselves,  indifferent  as  to  his  fate;  not 
even  a  dumb  animal  to  care  for  him  or  mourn  his  loss!  All 
that  remained  was  soon  accomplished,  and  he  has  found  rest 
at  last,  after  his  twenty-five  years  of  tossing  and  stumbling 
and  suffering  through  his  vagrant  and  crim.inal  life,  in  the  ash 
heap  of  the  Potter's  Field." 

"Some  Good  Ones. 

December  20,  1883. 
"A  pleasant  change  from  Edmunds  is  Daniel  C,  a  boy  of 
sixteen  years  of  age,  who  came  to  Ward  No.  3,  Men's  Surgical, 
about  nine  days  ago.  He  is  from  a  rough  country,  Schuylkill 
County,  a  mining  district,  where  his  occupation  was  to  drive 
mules  in  connection  with  the  mining  operations.  In  spite 
of  the  ruggedness  of  his  surroundings,  his  disposition  developed 
into  a  combination  of  gentleness,  patience,  and  sweet  reason- 
ableness that  is  rarely  to  be  met  in  this  house.  Every  one  in 
the  ward  likes  the  boy,  even  the  roughest  and  toughest,  and 
all  are  willing  to  help  him  in  such  way  as  is  possible.  I  have 
not  yet  had  a  patient  in  whom  I  have  felt  so  much  personal 
interest.  But  the  poor  fellow  has  no  prospect  of  recovery.  He 
has  a  tumor  almost  as  large  as  his  head,  which  is  growing  from 
the  back  of  his  neck,  infiltrating  the  surrounding  tissues  and 
extending  into  the  carotid  region  of  both  sides.  It  is  a  small 
round  cell  sarcoma  of  exceptionally  rapid  growth.  *  *  * 

The  boy  never  complains.     He  is  perfectly  satisfied  with 


31 

everything  about  him  and  is  always  cheerful  and  brave.  Some 
of  his  relatives  who  live  in  Philadelphia  come  to  see  him  occasion- 
ally, and,  this  evening,  it  was  my  unpleasant  duty  to  tell  one 
of  his  family  that  there  was  little  hope  that  the  boy  could  live, 
except  for  a  very  short  period.  It  is  a  rare  picture  and  a  very 
pleasant  one  to  me,  this  little  glimpse  that  I  have  had  of  what 
was  evidently  a  very  pleasant  home  life.  The  people  were 
all  poor  and  compelled  to  work.  My  patient  was  the  oldest 
son  and  did  much  towards  the  support  of  the  family  in  which 
each  member  was  doing  his  or  her  part.  He  was  able  to  earn 
about  thirty-five  dollars  each  month.  Always  at  home  after 
his  work  was  finished,  he  spent  the  evenings  reading  books  that 
would  give  him  some  start  at  an  education.  He  was  entirely 
different  from  the  men  and  boys  of  his  mining  town,  but  is  free 
from  all  priggishness  or  the  peculiarities  that  we  associate 
with  the  victims  of  *  early  false  piety.' 

Another  good  patient  for  whom  I  feel  much  interest  is 
Henry  G.  During  Edmunds'  last  days  G.  watched  by  him 
constantly,  enduring  with  patience  his  complaints,  curses,  blows, 
and  bites,  and  did  all  in  his  power  for  the  patient's  comfort. 
He  has  a  thin,  dark,  sad  face  which  itself  speaks  of  a  history, 
but  of  this  I  know  nothing  except  that  he  has  served  in  the 
United  States  Navy  and  is  a  native  of  Salem,  Mass.  I  did 
not  learn  that  he  was  a  fellow  Yankee  until  a  few  evenings 
ago,  and  naturally  my  interest  in  him  was  increased.  He 
makes  a  good  assistant  in  the  ward,  does  his  work  faithfully, 
and  is  always  anxious  to  be  of  help.  C.  and  G.  and  a  few 
others  are  as  rare  gems  amid  the  mass  of  human  rubbish 
which  lies  in  and  about  this  place.  It  is  a  pleasure  to  work 
for  such  as  these,  and  to  try  to  give  them  relief.  One 
feels  that  sympathy  is  not  thrown  away.  Of  course  we  work 
for  all  alike,  but  it  is  hard  to  worry  and  toil  over  a  man  who 
would  pick  your  pocket,  if  he  had  the  chance,  or  who  might 
break  your  head  if  there  was  any  cash  in  the  undertaking,  or 


32 

who  rewards  your  efforts  with  false  and  servile  flattery  that 
has  no  true-heartedness  in  it  and  cannot  be  taken  seriously." 

"New  Year's  Eve. 

December  31,  1883. 

" New  Year's  Eve  to-night,  and  to-morrow  is  1884!  Now 
for  turning  over  new  leaves,  making  resolutions,  signing  pledges, 
taking  vows!  With  me  the  greatest  change  that  the  New 
Year  brings  is  the  fact  that  I  'go  off  the  surgical'  and  'go  on  the 
nervous.'  This  will  be  a  relief.  Too  much  night  work  now. 
I  was  up  all  of  last  night  until  three  o'clock  in  the  morning, 
and  am  to  be  called  at  three  o'clock  to-morrow  morning.  New 
Year's  Day,  to  relieve  my  colleague  V.,  who  is  now  watching 
by  my  man  of  last  night.  I  ought  to  be  expressing  fitting 
sentiments  for  the  'ringing  out'  business,  but  will  go  to  bed  and 
sleep  through  the  change  of  years." 

"A  Night  Ride  on  the  Ambulance. 

January  7,  1884. 

"The  night  of  January  6th  was  bitter  cold.  Outside,  an 
icy  feeling  was  in  the  air.  One's  breath  froze  as  it  left  the 
face.  A  splendid  fire  burned  in  our  stove  and  the  room  had 
an  unusually  cheerful  and  at-home  appearance,  in  contrast 
to  the  manifest  discomforts  that  existed  beyond  the  walls. 
A  knock  came  at  the  door.  'Dr.  Bliss.  Ambulance,  Sir!'  There 
was  no  escape.  The  only  thing  to  do  was  to  bundle  up  as 
warmly  as  possible  and  go  forth  into  the  cold,  cold  night.  It 
was  bright  moonlight,  and  the  stars  shone  like  vivid  dots  of 
fire  snapping  in  the  clear,  open,  purplish-black  sky;  a  typical 
clear  winter  night,  when  the  snow  creaks  under  one's  feet  and 
one  can  almost  see,  as  well  as  feel,  the  cold.  Passing  through 
the  front  offices  I  found  the  ambulance  waiting  for  me  by  the 


33 

entrance.  'Where  to?'  I  asked,  'and  on  whose  order?'  *0h, 
it's  from  the  Central  Station!  We've  got  to  go  to  4  N.  Front 
St.'  Small  comfort  the  driver's  reply  gave  me,  but  we  climbed 
in,  and  away.  It  was  a  long  ride,  down  Chestnut  vStreet,  lighted 
by  its  electric  lights.  The  pavements,  usually  so  crowded,  are 
bleak  and  deserted  on  this  cold  Sunday  night.  We  have  the 
track  pretty  much  to  ourselves,  except  when  the  rapid  pace 
of  our  horse  brings  us  up  behind  a  street  car.  Bong!  Bong! 
goes  our  bell.  The  car  stops.  We  turn  off  the  track  and 
jolt  heavily  over  the  stone  paving  covered  with  icy  mounds  of 
snow.  Heavily  again  we  roll  on  to  the  track,  and  once  more 
away,  flying  onward  as  fast  as  the  strong,  fast  horse  can  drag 
the  rather  light  wagon.  Policemen  run  to  the  corners.  Bong! 
Bong!  'Off  the  track  there  in  front!'  On  we  rush  past  well- 
known  stores  and  theatres  and  street  crossings.  On,  on  in  a 
wild  whirl  of  speed.  The  horse  slips,  sparks  flash  from  beneath 
his  feet,  but  he  is  steady  again  and  doing  his  best.  How  strange 
the  familiar  streets  look  on  this  bitter  cold  January  night! 
And  for  what  are  we  going?  Is  it  some  crazy,  mad  creature,  to 
be  seized,  bound,  and  handcuffed,  and  carried  back  shrieking 
to  the  Madhouse?  Is  it  the  result  of  some  drunken  brawl? 
A  crowd  of  men;  a  blood-covered  and  bleeding  figure  on  the 
floor;  sounds  of  cursing  and  broken  sobs  and  the  low  muttering 
of  hushed  voices!  We  know  not  what  the  errand  may  be, 
but  still  onward  flying  through  the  cold  and  darkness.  We 
have  left  the  lighted  thoroughfares  and  have  turned  up  Second 
Street,  dimly  illuminated  by  far-apart  gas  lamps.  We  approach 
a  part  of  the  City  which  is  new  to  me.  It  is  one  of  the  worst 
neighborhoods  in  Philadelphia,  CaUowhill  Street  near  the  Dela- 
ware River.  We  enter  a  space  wider  than  the  ordinary  streets. 
Houses  of  irregular  size  and  shape  stand  farther  back,  giving 
a  more  open  appearance  to  the  roadway.  Gaunt  outlines  of 
factories  tower  aloft,  their  sides  and  chimneys  silvered  with 
moonlight,  while  dark  shadows  lurk  in  angles  and  corners  and 


34 

about  the  lower  stories.  Doors  of  grogshops  open  stealthily. 
Faces  peer  out  into  the  night  and  vanish  back  again.  We 
are  at  the  top  of  what  looks  like  a  steep  descent.  It  was  once, 
in  far-off  days,  the  quiet  river  bank,  where  trees  grew  and 
shaded  mossy  slopes;  for  the  moonlight,  flooding  down,  gleams 
on  a  space  of  glancing  whiteness  where  the  river  moves  and 
tosses  broken  masses  of  floating  ice.  A  mere  glimpse  we  have 
of  this,  down  a  narrow  way  of  blackness,  descending  tunnel- 
like between  the  dark  walls  of  lofty  buildings.  Turning  into 
Front  Street  the  ambulance  stops  before  a  mass  of  ancient, 
worn,  and  decaying  houses.  'Where  is  No.  4 — ?'  I  take  the 
lantern  and  jump  to  the  pavement.  A  man  slouches  across 
the  street  out  from  some  shadows.  'There's  the  place!'  He 
points  to  an  archway  leading  apparently  into  nowhere,  if  one 
can  judge  from  the  blank  darkness  of  the  passage  of  which  it 
forms  the  entrance.  I  ascend  the  steps  of  the  adjoining  house 
and  try  the  door.  It  is  locked.  A  series  of  loud  knocks  appears 
to  make  little  effect  on  the  stony  hearts  within.  There  is  a 
sort  of  glass-covered  slide  in  the  door,  a  small  space  but  large 
enough  to  enable  one  within  to  glance  out  into  the  street.  This 
slide  is  now  cautiously  opened,  and  a  villainous-looking  face 
gazes  out;  low  forehead  over  which  a  mass  of  tawn)^  matted 
hair  hangs  stiffly;  a  thick  unkempt  beard;  e3^es  which  search 
and  search,  as  though  hunting  for  crime  or  escape  from  its 
consequences.  These  eyes  look  quickly  at  my  face.  They 
see  a  uniform  cap  and  brass  buttons.  The  slide  closes  quickly 
and  decidedly  and  with  an  air  of  finality.  There  is  nothing  to 
be  done  but  to  enter  the  dark  passage.  Here  I  am  soon  sur- 
rounded by  strange,  half-clad  savages,  mostly  young  girls  and 
women,  although  a  few  men  slouch  about  here  and  there.  'Yes! 
This  is  the  place!  Come  along!  We'll  show  you  the  way!' 
Up,  up  I  go,  with  these  strange  guides,  the  bedraggled  looking 
outcasts  hidden  away  in  this  resort  of  vice  and  crime  and  poverty. 
The  stairs  are  worn   and  old.     Filth  is  everywhere,   and  the 


35 

cold,  damp  air  is  heavy  with  foul  odors.  The  walls  and  floor 
are  smeared  with  stains  of  many  colors.  In  a  little  room, 
high  up,  with  no  furniture,  bare,  bleak,  and  desolate,  its  one 
window  broken  and  admitting  the  winter's  bitter  cold,  there 
the  patient  lay.  She  was  a  little,  thin,  pinched,  and  withered 
old  woman,  the  very  ideal  of  a  hag.  She  lay  upon  the  filth- 
bestrewn  floor  almost  naked,  and  with  nothing  to  protect  her 
from  the  cold  but  an  old,  ragged,  straw  ticking.  'Don't  go 
near  her!  She's  alive  with  them!'  warned  some  one.  Well 
know  I  what  this  means!  The  old  lady  starts  up  and  looks 
interested.  Yes,  she  will  go  along  with  us.  Evidently  this  case 
does  not  require  imm.ediate  medicine.  The  usual  questions  are 
asked  and  answered,  and  then  they  make  her  ready  for  her  jour- 
ney. Never  before  had  I  seen  the  charity  of  the  poor  for  the 
poor  so  well  set  forth.  I  was  among  the  lowest  of  the  low,  people 
so  wretchedly  poor,  that,  in  Philadelphia,  the  city  of  cheap 
homes,  they  housed,  or  rather  kenneled,  in  this  rotting  tene- 
ment. I  don't  suppose  they  knew  much  of  the  fine  distinctions 
between  right  and  wrong.  I  don't  imagine  that  their  ideas  of 
morality  were  exact  and  nice.  I  strongly  suspect  that,  like 
beasts,  they  lived  in  promiscuous  intercourse,  but  a  wave  of 
emotionalism  or,  perhaps,  divine  pity,  swept  over  them,  and 
between  them  all  they  dressed  that  lice-covered  old  woman 
as  best  they  could.  One  gave  a  pair  of  stockings.  Another 
brought  out  from  some  corner  a  skirt.  A  shawl  was  contributed. 
And  so  they  covered  the  candidate  for  Blockley  with  articles 
of  dress  that  must  have  left  sad  gaps  in  their  wardrobes.  And 
they  are  making  an  event  of  it  all!  It  is  an  excited,  good- 
natured,  almost  a  joyous  crowd,  that  gathers  about  the 
ambulance  in  the  street,  little  children,  besotted  men,  and 
miserable  girls  and  women.  It  is  really  the  event  of  the  season. 
Actually!  These  people  are  laughing  and  seem  happy!  Faith 
they  have,  more  humanity  left  than  I  had  given  them  credit 
for    possessing    in    all    their    sadly    tangled    lives.     'Good-bye! 


36 

Good-bye!'  We're  off-  again.  Bong!  Bong!  Off  through  the 
deserted  streets,  whirHng  away.  Rattle,  rattle,  rattle,  we  go 
over  the  crossings;  rumbling  heavily  over  the  bridge.  'How 
are  you  now?  All  right?  Warm  enough?'  'All  right,'  comes 
the  reply  from  among  the  blankets.  Bong!  Bong!  Off  we 
turn  from  the  main  streets  and  draw  near  the  hospital.  Home 
at  last!  Half  frozen!  How  good  and  warm  the  fire  feels,  and 
how  cozy  the  cheerful  lighted  room!  And  she  who  was  freezing 
to  death  in  the  rotting  tenement  is  washed,  clad  in  warm,  clean 
clothes,  and  tucked  into  bed  in  the  first  decent  resting  place 
her  old  bones  have  lain  upon  for  these  many  months.  Another 
piece  of  driftwood  tossed  hither  on  the  tides  of  life!  Here  is 
peace.  But  the  tenement,  there,  is  still  full.  There  still  live 
crime  and  miserj^^.  'The  poor  ye  have  always  with  you!'  Yes, 
the  poor  and  the  vile.  What  hope  for  them?  The  busy  life 
of  trade,  of  pleasure,  of  gain,  goes  briskly  on.  It  is  not  for 
them.  Youth  is  beautiful  and  has  so  much  of  happiness.  It 
is  not  for  them.  For  them  is  a  blank  existence  of  indefinite 
days  with  misery  always;  now  and  then  some  gleam  of  what 
joy  might  be.  For  them  is  a  dreary,  dull,  monotony  of  want, 
hunger,  misery,  cold,  and  heat;  brief  gladness,  most  always  in 
relation  with  wrongdoing.  And  all  the  year,  below  them, 
tossing  in  winter  the  broken  ice,  floating  dead  driftwood  in 
summer,  runs  the  River,  and  to  many  of  them  it  gives  peace. 

"  '  Who  will  miss  them  there  to-morrow, 

Waifs  which  drift  to  the  shade  or  sun? 
Gone  away  with  their  songs  and  sorrow, 
Only  the  river  still  flows  on.' " 

In  the  days  of  the  diary  the  resident  physicians  were  served 
by  two  men,  who  were  called  the  "Doctors'  runners,"  and  by  a 
middle-aged,    kindly,    almost    motherly    woman    who    looked 


37 

after  the  laundry  and  had  general  oversight  of  the  care  of  the 
rooms.  Our  men  were  Sam  and  Billy.  It  was  a  belief,  accepted 
without  any  exact  data,  that  both  these  men  had  found  their 
way  into  the  institution  through  the  door  of  the  vSeventh  vStreet 
Office.  Everybody  except  the  higher  officials  appeared  to  have 
gained  entrance  to  Blockley  by  that  way,  rising  in  the  social 
grade  of  the  Almshouse  community  to  a  position  that  cor- 
responded with  their  abilities.  A  large  number  of  the  attendants 
also  were  friends  or  hangers-on  of  members  of  the  Board  of 
Guardians,  and  were  placed  in  office  by  such  influence.  Sam 
was  a  nervous,  quick-moving,  shallow-brained,  but  most  vvdlling 
servant.  Billy,  who  had  but  one  active  eye,  was  older  than 
Sam,  was  slow,  deliberate,  somewhat  pessimistic  in  his  views 
on  men  and  life,  disposed  to  have  sentiments  of  profound  depth 
without  the  verbal  ability  to  express  them  clearly.  He  had 
seen  many  generations  of  resident  staffs  come  and  go,  during 
his  term  of  service,  and  knew  somewhat  of  the  general  char- 
acter of  the  average  young  medicus.  There  is  a  reference  to 
Billy  in  the  diary  that  is  somewhat  characteristic. 

"By  the  Way. 

January  16,  188-1. 
"No  one  can  deny  that  Blockley  residents  are  not  kept  actively 
busy.  I  think  that  we  earn  our  salt.  Billy  came  into  our 
room,  the  other  evening,  to  light  the  gas.  The  burner  leaks 
out  a  little  of  this  volatile  substance  which  we  try  to  imagine 
gives  some  illumination,  but  it  does  not.  In  regard  to  this 
matter  we  labor  under  an  unsystematized  delusion.  But  gas 
is  expensive,  more  or  less,  and  the  Board  of  'Guardeens'  is  bent 
upon  economy.  Well,  the  antiquated  and  slow-moving  Billy 
came  shuffling  into  the  room.  I  remarked  to  him  something 
about  the  rapid  flight  of  time  here,  especially  when  one  had  much 
work.  Billy  stood  on  a  wooden  chair,  his  arms  stretched  at 
full  length  above  his  head,   endeavoring  with  unsteady  hand 


38 

to  insert  a  lighted  mafch  under  a  globe  of  the  chandelier,  and 
squinting  dreadfully  with  the  earnestness  of  his  efforts.  Pop! 
went  the  flame.  Billy  slowly  turned  around,  and  still  on  the 
chair,  but  in  imminent  peril  of  falling  off,  delivered  himself 
thus,  with  much  force  on  each  word  and  impressive  pauses 
between:  'Of  all  the  men  I've  seen  in  life,  I  have  never,  at  any 
time,  here,  seen  a  class  of  men  so  worked  as  the  present  resident 
staff!'  He  stepped  to  the  floor,  and,  suddenly  rousing  himself, 
demanded,  'Why  don't  you  strike?'  Being  told  that  this  was 
useless,  a  look  of  deep  melancholy  settled  in  his  one  remaining 
eye,  and  he  left  the  room,  sadly  remarking  in  the  depth  of  his 
sympathy,  that  it  was  'all  a  great  shame.' 

"We  cannot  very  well  strike,  but  certainly  there  is  much 
to  be  done.  Here  is  a  report  of  to-day's  work:  Out  of  bed  at 
half  after  seven  o'clock;  breakfast  at  eight.  Then  at  work  in 
the  wards  until  twelve,  making  my  rounds  and  applying  the 
large  battery.  I  am  snatched  by  a  runner  for  the  ambulance. 
Off  to  the  Seventh  Street  Office,  and  then  away  uptown  to 
North  Second  Street  near  Columbia  Avenue;  then  back  to 
Seventh  Street  and  out  to  the  Hospital.  Arrive  here  at  half 
after  two,  and  have  what  dinner  I  can  obtain  at  that  late  hour. 
Go  to  my  room  and  begin  writing  up  histories  of  cases  for  Dr. 
M.  Again  comes  the  runner  with  another  ambulance  call  which 
proves  to  be  a  false  alarm.  So  back  to  the  crazy  histories 
again.  Finish  these  by  five  o'clock.  Then  another  ambulance 
call  which,  again,  proves  false.  Very  fortunate,  this,  for  other- 
wise I  should  have  had  the  pleasure  of  a  visit  to  Bandbox  Row, 
away  up  in  the  slums  of  Richmond.  I  now  go  to  the  wards 
and,  while  making  my  evening  rounds,  Dr.  M.  appears.  Five 
students  are  with  him,  and  he  lectures  to  his  class  until  almost 
seven  o'clock.  As  a  result,  I  nearly  lose  ray  supper.  After 
this,  I  make  my  rounds  in  the  Erysipelas  wards  and  then  go  to 
my  room.  Here  I  try  to  read,  but  fall  asleep  over  the  book; 
so  that  nov/,  about  the  hour  of  ten,  I  am  full  ready  for  bed. 


39 

There  are  easier  stations  in  life  than  that  occupied  by  a  resident 
physician  in  Blockley." 

The  wards  for  patients  suffering  from  diseases  of  the  nervous 
system  were  the  most  primitive  in  their  equipment  of  any 
department  at  Blockley.  They  consisted  of  two  groups  of 
long,  one-storied,  wooden  pavilions,  separated  by  a  wide  road- 
way that  led  in  from  Thirty-fourth  Street.  The  pavilions  on 
the  north  of  this  roadway  v/ere  for  women  and,  on  the  southern 
side,  for  men.  These  thin-walled  structures  were  raised  about 
three  feet  above  the  ground  and  were  lighted  by  long  narrow 
windows.  The  students,  visiting  the  public  clinics  in  large 
numbers  on  Wednesdays  and  Saturdays,  entered  the  grounds 
by  the  gate  on  Thirty-fourth  Street  and  passed  along  the 
avenue  between  the  groups  of  pavilions  to  the  door  leading  to 
the  clinic  amphitheatre.  These  cheerless,  ill-equipped,  wooden 
structures,  hardly  better  than  shacks,  had  been  erected  for  the 
nervous  patients,  because  no  space  remained  available  within 
the  walls  of  the  main  hospital  buildings.  It  is  probable  that 
these  pavilions  were  never  intended  as  permanent  buildings, 
but  must  have  been  designed  to  meet  an  urgent  need,  at  a  time 
when  the  Guardians  were  economical  or  stingy.  Every  phase 
of  chronic  disease  of  the  nervous  system  was  represented  in 
these  wards,  and  the  acute  cases  were  numerous  and  interest- 
ing. No  finer  school  could  have  been  found  for  the  study  of 
this  class  of  patients,  especially  as  the  most  able  neurologists 
of  the  City  had  terms  of  service  in  this  department  of  the 
Hospital.  One  pavilion  in  each  group  was  reserved  for  patients 
suffering  from  epilepsy.  The  attendants  were  few  in  number 
and  chosen,  as  throughout  the  hospital,  from  available  con- 
valescent patients,  or  were  temporary  helpers  who  might  leave 
us  at  any  time.  The  Head  Nurses  corresponded  with  the 
same  class  as  in  the  other  v.^ards  of  the  Hospital.  Among  the 
patients,    especially    in    the    wards    for    epileptics,    were    many 


40 

who  were  on  the  border  line  between  eccentricity  and  insanity. 
It  was  not  an  infrequent  occurrence  to  transfer  an  uncertain 
case  to  the  Department  for  the  Insane,  after  systematized 
delusions  had  developed,  and  there  was  need  for  more  secure 
and  better  organized  means  of  restraint  than  we  could  supply. 
The  epileptic  patients  required  careful  oversight;  and  yet  the 
poor  victims  themselves  were  most  willing  to  aid  one  another 
when  seizures  occurred.  The  diary  has  a  reference  to  some  of 
the  peculiar  denizens  of  the  nervous  wards,  under  the  title  and 
date 

"Fai.se  Liv:es. 

February  17,  1884. 
"Sunday  morning.  Rain  and  darkness.  A  dull,  heavy 
day  filled  with  suggestions  of  erysipelas,  malaria,  and  numerous 
lung  affections;  filled  too  with  far  from  cheerful  thoughts  of 
the  unattainable.  To  disperse  these  we  need  only  a  few  con- 
secutive days,  or  even  hours,  of  sunshine.  Two  weeks  of  dark 
and  dismal  days  have  favored  the  growth  of  gloom.  All  my 
patients  have  numerous  new  and  unaccountable  aches  and 
pains.  In  my  ward  are  several  half  insane  persons  of  a  greater 
or  less  degree  of  crankiness.  One  gentleman,  Henry  C — s,  is 
badly  deranged  upon  the  subject  of  religion.  His  ideas  are 
crude,  but  much  resemble  many  of  the  primitive  beliefs  of 
several  old  races,  as  well  as  some  of  the  ancient  schools  of 
philosophy.  He  thinks  that  men  should  so  live  as  to  worship 
the  Great  Cause,  whose  name  he  seldom  mentions,  speaking 
of  God  in  a  roundabout  manner.  He  generally  refers  to  the 
Deity  in  a  long  sentence  which  I  have  heard  him  repeat  so 
often  that  the  formula  is  stamped  in  my  memory.  I  asked 
him  to  describe  his  idea  of  the  Great  Cause,  and  he  answered 
thus,  'The  truest,  purest,  surest,  most  holiest  and  most  power- 
fulest  power  of  all  powers.  The  principal  power  of  all  powers. 
The  beginner  and  maker  of  all  and  of  everything,  visible  and 
invisible,  known  and  unknown,  to  all  and  to  every  one;    whose 


41 

name  we  don't  know,  but  I  hope  will  know  some  day,  as  we 
meet  on  the  way.' 

"This  morning  he  came  to  me  as  I  was  leaving  the  ward, 
having  made  my  rounds,  and  said:  'You  asked  where  the 
principal  power  of  all  powers  lives.  This  morning  while  eating 
it  came  to  my  mind  that  he  lives  in  the  whole  world,  for  you 
find  life  everywhere — the  smallest  ants  and  creeping  things  in 
the  ground;  and  I  don't  think  men  ought  to  kill  them  for  food 
— as  killing  sheep  and  bullocks — or  for  other  reasons,  for  they 
are  made  by  the  principal  power  of  all  powers,  that  is  Jesus 
Christ.  I  believe  every  man  ought  to  have  a  wife.  My  father 
meant  me  for  the  priesthood,  but  I  refused  to  be  a  priest  for 
they  don't  marry.'  He  informed  me,  the  other  day,  that  his 
thoughtful  and  far-seeing  parent  'had  me  cut  for  stone,  so  as 
to  keep  me  from  doing  wrong  when  I  got  old.'  I  fear  that 
this  operation,  whatever  it  may  have  been,  has  not  been  success- 
ful. Henry's  religious  and  ethical  sentiments  are  as  noble  as 
those  of  an  Indian  Buddhist,  and  his  habits  of  life  quite  dis- 
gusting and  depraved.  When  not  prevented,  he  eats  and  drinks 
substances  that  are  fit  only  for  the  drains  and  sewer.  When 
asked  why  he  does  this,  and  when  threatened  with  punishment, 
he  replies  that  he  does  it  for  the  honor  of  the  principal  power 
of  all  powers;  that  he  made  such  substances,  and  that,  there- 
fore, they  are  not  unclean. 

"An  old  colored  woman  who  resides  in  one  corner  of  Ward 
II,  Women's  Pavilions,  is  very  talkative.  She  says  that  she 
has  always  lived  with  the  'quality,'  and  refers  with  much  scorn 
to  certain  'colored  gals  and  fat  black  women'  with  whom  she 
must  now  associate,  and  who  are  always  telling  lies  about  her. 
Religious  topics  arouse  her  into  a  high  state  of  hysterical  excite- 
ment. The  poor  old  lady  is  extravagantly  fond  of  ginger 
cakes,  and,  the  other  morning,  after  asking  me  for  a  supply  of 
these  crisp  and  snappy  delicacies,  she  cried  aloud,  'I'm  ready 
to  go  from  Earth  to  Glory  for  they  don't  give  me  enough  to  eat!' 


42 

"Directly  across  the  ward  from  this  woman  resides  a  white- 
haired,  hollow-eyed,  wild  and  cadaverous  looking  old  Scotch 
lad}^  who  is  very  noisy  and  violent  and  uses  the  vilest  language 
imaginable.  She  must  be  a  relative  of  Rob  Roy's  wife.  Many 
trains  of  thought  follow  one  another  without  rhyme  or  reason 
through  her  brain.  I  spent  a  dreary  afternoon  noting  down 
her  mutterings  for  Dr.  M.  If  he  can  make  any  head  or  tail 
out  of  her  talk,  that  will  be  of  value  to  the  science  of  medicine, 
it  will  be  a  remarkable  feat  of  the  imagination.  For  mere 
intellectual  amusement  I  would  recommend  him  to  try  a  picture- 
puzzle,  instead.  Unfortunately  the  dear  old  lady  was  not  in 
a  profane  mood  last  evening,  and  the  reported  monologue  was 
quite  commonplace  and  decent.  I  copied  down  a  few  of  her 
interesting  remarks, — 'He  was  born  this  side  of  dasher  and 
baptized  at  Douglass'  (mumble,  mumble,  mumble).  'Father 
McElhone  asked  me  why  I  didn't  sleep.  I  don't  sleep  any 
because  a  priest  and  a  bishop  put  their  hands  on  my  head  at 
night.'  'He  asked  what  was  the  prettiest  place  in  Scotland, 
and  I  said,  said  I'  (mumble,  mumble,  mumble).  'I  don't  see, 
says  he,  how  any  woman  could  have  picked  up  so  much.  She 
couldn't  have  it,  says  I,  if  she  hadn't  it  to  pick  up.'  Deep  and 
dangerous  talk  this!  Almost  as  clear  as  Browning!  This 
morning  an  old  colored  man,  having  only  one  eye,  the  other 
having  been  destroyed  by  some  disease,  came  to  me  and  an- 
nounced that  his  name  was  William  I — m,  and  that  he  was  seventy 
years  of  age  and  born  in  Maryland.  'I  am  the  greatest  grain- 
measurer  in  the  City  of  Philadelphia,'  said  he;  'well  known  to 
all  the  prominent  merchants  years  ago;  have  known  all  for  the 
last  thirty-five  years.  They  have  died  and  gone  now,  and  their 
children  coming  up.'  According  to  his  statement,  I — m  has 
a  serpent  lodged  in  the  left  iliac  and  hypogastric  region.  He 
slaps  his  abdomen,  and  the  creature  crawls  and  curls  about. 
It  has  spun  a  web,  he  reports,  which  extends  down  along  both 
legs  to  his  feet  and  also  up  into  his  brain.     It  covers  his  whole 


43 

body.  'I'm  webbed  entirely  in,' he  says.  'I  don't  know  whether 
I'll  live  through  an  operation,  but  I'll  have  it  taken  out.  When 
I  walk  the  web  spins  out  and  is  just  like  a  chain-ball.  It  Vv^on't 
let  me  go.'  This  snake  eats  all  the  man's  food.  'He  gits  his 
share  and  that  keeps  him  quiet.  Whether  I  took  it  in  drinking 
water,  or  how  it  got  in,  God  knows,  or  why.  People  are  so  bad 
in  this  world!' 

"So  these  people  and  many  others,  some  better,  some  worse, 
live  on  in  their  fancies  and  false  lives;  one  with  his  bosom 
serpent;  one  with  her  dream  of  ginger  cakes  and  glory;  one 
with  his  dark  deceiver  ever  at  hand  to  catch  him  off  his  guard; 
another  with  her  mixed  recollections,  talking  and  muttering 
of  things  past,  of  old  memories  mingled  together  without  order 
or  reason,  and  the  whole  dreamy  fabric  of  words  mortared 
together  with  cursing  and  blasphemy." 

"An  Afternoon  Walk. 

February  23,  1884. 
"This  month  has  contained  thus  far  nineteen  days  of  rain. 
One  almost  forgets  that  a  shadow  was  ever  cast,  and  the  sun 
is  becoming  a  mere  thing  of  past  history.  However,  yesterday 
afternoon  the  old  illuminator  did  appear  and  forced  a  few 
feeble  rays  of  light  through  the  lead-colored  clouds.  V.  and 
I  took  a  walk  out  Darby  Road.  The  day  really  was  delightful, 
all  the  pleasanter  for  the  long  series  of  clouds  and  storms  which 
had  gone  before.  There  was  a  gentle  and  suggestive  sense  of 
coming  »Springtime  in  the  air,  while  everywhere  the  grass  was 
bright  green,  and  every  road  was  wet  and  soft  with  the  melting 
frost.  Anywhere,  but  in  the  depressing  neighborhood  of 
Blockley  and  the  lower  reaches  of  the  Schuylkill,  the  voice  of 
the  turtle  would  have  been  heard  distinctly  had  one  been  about 
and  possessed  of  vocal  powers.  Yet,  in  spite  of  the  feeble 
Februar}^  sunshine,  it  was  rather  a  grey  day  and  a  grey  land 
through    which    we    walked.     Our    way    took    us    past    several 


44 

Church  Homes,  and  finally  turned  down  a  long  lane,  near  the 
Theological  Seminary  of  the  Episcopal  Church,  towards  the 
River,  which  we  soon  reached.  It  was  a  dreary  spot.  The 
clouds  had  gathered  again,  and  under  a  dead,  heavy  grey  sky, 
the  landscape  itself  seemed  grey  of  many  varying  dull  shades, 
with  no  bright  bits  of  coloring  to  relieve  the  monotony.  Here 
the  river  is  almost  on  a  level  with  its  banks,  and  on  either  side 
of  the  stream  extend  long  stretches  of  marsh  land,  white  at 
this  time  of  the  37"ear  and  covered  with  scant,  tall,  dried  grass 
over  which  a  moist,  chilly  wind  was  blowing  from  the  southward. 
Along  our  side  of  the  water  stood  huge  oil  tanks,  and  close  by 
were  the  low,  unsightly  sheds  and  furnaces  of  several  refineries. 
For  a  broad  space  about  them  the  ground  was  saturated 
black  and  dank  with  crude  oil.  The  river  itself,  bordered  bj^ 
lov7,  scrubby  willow  trees,  was  of  a  greyish  yellow  tint  flecked 
with  whitecaps  over  its  wind-ruffled  surface.  Across  the 
wide  river  low-lying  marsh  lands  stretched  away,  from  the  flat 
level  of  which  tall  chimneys  of  oil  works  rose  here  and  there, 
and,  at  a  distance,  two  huge  grain  elevators  loomed  aloft,  their 
slate-grey  roofs  and  sides  standing  out  clearly  against  the  lighter 
grey  of  the  lowering  sky.  Far  off  across  the  marshes  could  be 
seen  the  tall,  bare  masts  and  yardarms  of  several  bark-rigged 
ships  lying  at  anchor  in  the  Delaware.  Near  by,  moored  to 
a  wharf,  were  two  large  vessels  being  loaded  with  blue-colored 
barrels  of  petroleum.  We  walked  on,  going  down  a  railroad 
track  towards  the  City.  On  our  right  we  passed  a  large,  hand- 
some mansion,  built  in  English-manor  style,  which  stood  on 
a  knoll  above  the  river  and  its  marshes,  and  was  almost  sur- 
rounded by  trees.  Through  these  we  caught  glimpses  of  the 
building  as  we  passed.  Its  windows  were  all  closed  and  boarded 
up.  In  many  places  plastering  had  fallen  from  the  stuccoed 
walls.  Evidently  the  place  had  been  shut  up  and  deserted  long 
ago,  for  young  trees  had  sprouted  up  thickly  in  what  had  once 
been  a  well-kept  grove,  which  was  now  dense  with  tall  under- 


45 

brush  and  tangled  thickets.  As  if  the  ghostly  and  uninviting 
aspect  of  the  place  were  not  sufficient  to  warn  off  visitors,  a 
large  sign  had  been  placed  facing  the  railroad,  which  threatened 
all  the  law's  penalties  upon  any  one  who  ventured  within  the 
high,  briar-covered  stone  walls  enclosing  the  estate.  We 
trespassed  not,  but  I  fancy  that  within  the  house  were  large 
empty  rooms;  perhaps  in  some  the  remains  of  old  furniture, 
rolls  of  worn-out  carpeting,  broken  china,  all  the  debris  left 
behind  in  a  place  which  had  once  been  a  home.  Even  old 
Blockley  wore  a  cheerful  aspect,  when  I  returned  to  it  wnth 
a  vision  of  this  deserted  mansion  in  my  mind. 

"I — m,  the  man  who  imagines  that  a  serpent  is  within  him, 
told  me  this  morning  that  I  might  as  well  stop  giving  him 
medicine;  for  although  he  confessed  to  feeling  better,  he  said 
of  the  snake:  'It  is  something  which  neither  you  nor  your 
forefathers  ever  saw.  It  was  put  on  me  by  God,  and  I  would 
not  have  it  taken  away.  Barnum,  Sir!'  he  said,  striking  his 
chest,  while  he  straightened  up  and  glared  wildly  with  his  one 
and  only  eye,  'Barnum,  to-day,  would  give  a  thousand  dollars 
for  my  exhibition  in  a  show!'  Poor  William  is  fast  v/orking 
himself  into  a  candidate  for  admission  to  our  associated  institu- 
tion across  the  great  courtyard,  where  the  insane  have  their 
habitation." 

"Relaxation. 

March  2,  1884. 

"The  other  evening,  Dr.  R.  came  into  the  room.  I  had 
out  my  fiddle,  and  V.  and  he  endeavored  to  sing  while  I  picked 
out  an  accompaniment.  As  a  performance,  although  satis- 
factory to  us,  it  was  not  entirely  a  success,  and  was  most  un- 
favorably received  by  our  colleagues  in  the  adjoining  billiard 
room.  Later  in  the  evening  we  joined  the  billiard  players  in 
the  great  entry,  together  with  others  of  the  staff  just  back  from 
hospital  duty,  and  improvised  a  stag  ball.  I  stood  on  a  chair 
and  fiddled  waltzes  while  R.  and  V.  and  M.  and  the  others 


46 

gallivanted  around  over  the  floor,  sometimes  in  couples,  or  each 
one  singly  embracing  a  chair  for  a  partner.  These  dances  were 
followed  by  a  grand  quadrille,  in  which,  as  the  fiddler  took 
part,  we  had  no  more  effective  music  than  the  rhythm  of  our 
heavy  tread.  Action  was  strong  and  the  figures  mixed,  while 
a  general  din  of  shouting  kept  up  the  enthusiasm.  This  soon 
resolved  itself  into  a  game  of  leapfrog.  Up  and  down  the  long 
hall  we  went.  It  was  no  joke  to  go  over  the  backs  of  the  six- 
footers,  but  it  was  still  less  of  one  when  they  went  over  your 
own.  Leapfrog  suggested  a  contest  in  running  and  jumping. 
Two  piles  of  tables  and  chairs  were  placed,  one  on  either  side 
of  the  entry.  The  narrow  strip  of  carpeting  that  adorns  the 
centre  of  our  entry  was  taken  up  and  stretched  across  the  hall 
between  the  piles  of  furniture.  This  was  the  line,  and  was 
cleared  by  a  running  jump,  after  which  it  would  be  placed 
higher  and  the  contest  continued.  Tiring  of  this,  we  chose 
sides  for  a  rope-pull,  using  the  dear  old  carpet  for  a  rope;  and 
so  the  evening  ended  with  two  rounds  of  a  tug-of-war,  in  which, 
of  course,  victory  was  claimed  by  both  sides.  It  is  this  sort 
of  gentle,  intellectual  amusement  that  excites  the  suspicions 
of  our  new  Superintendent,  Mr.  S.  A  more  wholesome  and 
yet  sober  group  of  young  fellows  never  served  on  a  Blockley 
resident  staff,  but  Mr.  S.  is  sure  that  the  noise  that  occasionally 
disturbs  the  evening  hours  and  is  wafted  across  the  great  court- 
yard to  the  Front,  where  he  and  his  family  reside,  is  the  din 
that  attends  an  orgy,  and  he  doubts  the  morality  of  suffering 
it  longer." 

In  the  days  of  the  diary  the  resident  staff  of  Blockley  con- 
sisted of  eleven  men  and  one  woman.  The  Staff  of  1883-4 
was  quite  independent  in  respect  to  obligations  associated 
with  appointment,  as  all  of  its  members  had  won  their  places 
by  the  highest  averages  in  a  competitive  examination.  As 
a  result  of  this  method  of  choice  the  Hospital  had  obtained  an 


47 

unusually  efficient  and  conscientious  group  of  young  men. 
The  one  lonely  woman  was  a  graduate  of  the  Women's  Medical 
College  of  Philadelphia,  and  was  held  in  great  respect  by  her 
male  colleagues.  As  she  was  excused  from  certain  depart- 
ments of  the  hospital  work,  in  which  it  would  have  been  quite 
unfit  for  a  woman  to  serve,  a  slight  excess  of  labor  was  thrown 
on  the  eleven  men  of  the  Staff.  They  took  themselves  and 
their  work  quite  seriously,  but  had  that  buoyancy  of  disposi- 
tion common  to  the  American  college  man.  The  writer  could 
not  have  found  a  more  congenial,  self-respecting,  and  well- 
mannered  group  of  associates  than  were  his  colleagues  on  the 
staff  of  his  term.  Our  quarters  were  in  the  central  building 
of  the  Women's  Outwards,  the  Department  of  the  Almshouse 
for  Women.  We  occupied  rooms  opening  on  a  wide  hall,  on 
the  third  story  of  this  building,  and  were  assigned  rooms  in 
couples.  The  woman  physician  had  a  little  room  at  the  ex- 
treme end  of  our  hall,  and  must  have  been  rather  astonished 
and  somewhat  annoyed  at  the  noise  made  by  her  professional 
brothers,  when  this  hall  served  as  a  football  field  or  space  for 
track  athletics  or  boxing.  One  room  of  the  series  was  unoc- 
cupied, and  in  this  we  had  a  billiard  table  which  was  rented 
and  paid  for  by  subscription  collected  from  the  members  of  the 
staff.  The  rooms  were  spacious,  with  very  high  ceilings  and 
each  room  had  one  large  window  so  high  above  the  floor  that 
a  platform  was  built,  a  sort  of  dais,  beneath  it,  so  that  the 
occupants  of  the  room  could  be  seated  and  yet  look  out  upon 
the  external  world.  Here  the  writer  and  his  genial  roommate, 
Dr.  v.,  lived  on  terms  of  cordial  intimacy.  Dr.  V.  was  a  tall, 
well-built,  soldierly-looking  man,  rather  impulsive,  not  always 
well-balanced  in  his  moods  and  tenses  of  self-control,  but  warm- 
hearted and  loyal  to  his  friends.  One  afternoon,  the  writer 
returned  to  his  room,  after  some  duty  in  the  wards,  and  saw 
his  roommate  standing  erect  at  the  window,  his  broad  straight 
back  presented  to  the  interior  of  the  apartment,  and  his  face 


48 

to  the  rather  dreary  outlook  over  weed-covered  fields  and 
vacant  lots.  It  was  not  apparent  what  train  of  thought  passed 
through  Dr.  V.'s  mind;  perhaps  longings  for  the  Springtime, 
when  he  was  to  go  forth  into  the  wide,  wide  world,  free  to 
establish  a  private  practice.  At  all  events,  with  hands  thrust 
deep  in  the  wide  pockets  of  his  uniform  coat,  head  erect,  and 
face  to  the  world,  he  was  singing  in  a  thoughtful  but  most 
expressive  manner  this  song, — 

"I'm  old  and  helpless  and  feeble, 

The  days  of  my  youth  have  gone  by. 
So  it's  over  the  hill  to  the  Poorhouse; 
I'll  wander  alone  there  to  die." 

The  contrast  between  that  big,  well-built  mass  of  human 
energy  and  the  song  of  despair  was  most  amusing.  And  yet, 
I  think  that  we  all  of  us  felt  a  depression  of  mood,  that  came 
as  waves  over  our  youthful  spirits,  during  those  twelve  months 
among  the  associations  of  old  Blockley.  From  the  central 
building  in  which  our  rooms  were  placed,  two  long  extensions 
ran  east  and  west.  The  lowest  stories  were  occupied  by  the 
old  women  paupers.  In  the  upper  story,  or  attic,  the  local 
title  for  which  was  "Dandy  Hall,"  were  the  women  awaiting 
confinement  in  the  obstetrical  wards,  which  also  occupied 
other  portions  of  this  same  floor.  In  those  days  puerperal 
fever  was  so  common  in  Blockley,  that  we  had  a  ward  especially 
devoted  to  the  victims  of  this  infection.  Its  beds  were  always 
occupied.  Asepsis  was  almost  unknown.  The  writer  remembers 
that  when  it  became  his  turn  to  serve  in  the  obstetrical  wards, 
it  was  agreed  between  Dr.  M.,  his  colleague,  and  himself,  that 
during  their  term  of  this  service  they  would  discard  their  old 
hospital  uniforms,  wear  civilian  dress  that  had  never  been 
used  about  the  hospital,  remain  away  from  the  main  hospital 
itself  as  much  as  possible,  and  use  the  utmost  cleanliness  in  all 
operative    work    connected    with    their    service.     We    had    no 


49 

case  of  puerperal  fever  during  our  term  of  service.  Yet  this 
was  partly  a  coincidence  or  good  luck;  for  the  walls,  floors, 
and  furniture  of  those  old  rooms  must  have  been  loaded  with 
streptococci,  staphylococci,  pneumococci,  and  all  the  noble 
army  of  the  bacillus  gens.  Our  only  efficient  nurse  was  a 
middle-aged  woman  who  had  large  experience  in  midwifery. 
She  was  a  small,  lightly-built,  and  most  energetic  individual, 
quick  in  all  her  movements,  prompt  in  decision  and  in  action. 
Her  practical  knowledge  of  her  subject  was  superior  to  our 
theoretical  training,  however  much  more  scientific  the  latter 
may  have  been.  We  could  depend  upon  her  to  call  us  from 
our  sleep  to  active  service  not  one  moment  sooner  than  the 
necessities  of  the  moment  required,  but  when  that  call  came 
there  was  to  be  no  delay.  Her  manner  towards  us  was  a  quaint 
combination  of  motherly  interest,  good-natured  amusement, 
and  professional  respect.  It  was  fortunate  for  us,  as  well  as 
for  the  patients,  that  she  was  at  hand,  especially  during  the 
early  days  of  a  change  of  service  and  the  incoming  of  new  and 
inexperienced  doctors.  Most  of  our  patients  were  primiparas, 
women  with  their  first  children,  young,  ignorant,  without  any 
self-control,  sometimes  with  instincts  and  manners  like  savages. 
Of  course  very  few  of  them  were  married.  In  rare  instances, 
the  mothers  manifested  a  real  and  lasting  interest  in  their  chil- 
dren, but  usually  the  feeling  was  an  evanescent,  physiological, 
maternal  instinct,  not  as  deep  or  as  serious  as  a  cat  would  feel 
for  its  kittens,  or  a  cow  for  its  calf.  Rarely  would  the  mother 
care  to  give  a  name  to  the  unwelcome  offspring.  As  some 
name  had  to  accompany  our  report  of  a  birth  made  to  the 
Bureau  of  Health,  the  resident  physicians  gave  such  children 
any  names  that  a  passing  mood  might  suggest,  and  some  of 
these  young  citizens  received  as  remarkable  names  as  were  ever 
given  to  a  human  being.  Fortunately  such  titles  were  not 
legally  binding,  and  a  respectable  name  could  be  bestowed  at 
the  time  of  the  child's  christening. 


50 

Below  our  quarters  extended  a  series  of  rooms  and  wards 
for  the  women  paupers.  Most  of  the  wards  were  great  square 
rooms  in  which  the  beds  were  placed  around  the  walls  at  in- 
tervals, in  corners,  and  through  the  center.  A  few  favored 
souls  obtained  "cubbies."  These  were  cell-like  spaces  of  a  few 
feet  square,  large  enough  to  contain  a  bed,  a  small  table,  and 
a  chair.  The  occupant  of  a  "cubbie"  was  invariably  a  denizen 
of  the  ward,  who  had  proved  her  right  to  consideration  by 
genial  manners,  cleanly  habits,  and  a  cheerful  observance  of 
all  the  rules  and  regulations  of  the  house.  Such  women  adorned 
their  small  cells  with  ornaments  and  pictures  chance  or  good 
fortune  might  bring  them,  and  took  as  much  pride  in  their 
narrow  dwellings  as  a  Queen  in  her  castle. 

The  diary  has  a  reference  to  the  Insane  Department.  This 
was  distinct  from  the  general  hospital  and  had  a  medical  staff 
of  its  own.  We  were  quite  free,  however,  to  visit  its  wards 
and  grounds  whenever  we  desired. 

"The  Inferno. 

March  4,  1884. 
"I  went  with  V.,  yesterday  afternoon,  through  the  Insane 
side.  It  was  something  like  a  descent  to  Purgatory,  if  not 
lower,  after  the  Virgil-Dante  fashion.  There,  in  large,  square, 
bare,  but  sunny  rooms,  sitting  on  wooden  benches  about  the 
walls  or  wandering  restlessly  up  and  down,  were  the  mad  in- 
mates. The  months  pass  and  seasons  change  but  no  change 
comes  to  them.  During  the  day,  when  not  out  of  doors,  they 
are  kept  in  large  'day  rooms.'  At  night  each  has  a  room  to 
himself  or  herself,  except  the  very  quiet  ones,  who  are  kept 
in  general  wards.  Each  one  has  his  peculiar  set  of  delusions 
concerning  which  many  will  converse  freely,  but  others  are 
very  reticent.  Each  seems  to  retire  into  a  little  world  of  his 
own,  a  false,  dream-world,  real  only  to  himself.  One  man, 
with   hands   firmly  fastened   in   a   muffler  which   confined   his 


51 

arms,  strode  softly  up  and  down  one  side  of  a  room,  every 
movement  filled  with  a  suppressed  energy.  His  restless  eyes 
saw  everything,  and  glared  with  a  baleful  look.  He  seemed 
to  be  waiting,  waiting.  When  the  release  came,  a  very  devil 
would  be  loose;  or,  on  the  other  hand,  his  evil  spirit  would 
be  tamed  and  in  subjection.  In  several  cells,  into  which  we 
looked  through  small  circular  windows,  were  raving  maniacs, 
some  yelping  like  dogs,  one  apparently  in  a  kind  of  wicked 
ecstasy.  The  walls  of  these  cells  were  padded.  Scattered 
throughout  the  various  rooms  and  in  the  grounds,  I  saw  many 
of  my  old  patients  whom  we  had  transferred  from  the  nervous 
wards.  Michael  R.  was  there.  He  seemed  very  glad  to  see 
me.  I — m,  the  snake  man,  was  in  the  same  room.  He  had 
been  there  but  a  few  days  only,  and  expressed  himself  as  con- 
tented with  his  new  quarters.  He  shook  hands  with  me  warmly, 
and,  having  thanked  me  for  my  attention  to  him,  proceeded 
to  bestow  upon  me  a  very  formal  blessing.  He  told  me  that 
he  was  now  a  prophet,  and  that  he  controlled  the  winds  with 
his  right  hand  and  the  earth's  motions  with  his  left  foot.  From 
this  it  is  evident  that  I — m  is  rising  in  social  importance,  getting 
quite  a  little  confidence  in  himself,  and  developing  a  sort  of 
universal  influence.  In  another  room  I  met  Henry  C — s.  He 
did  not  remember  me,  but  was  still  willing  to  talk  about  the 
principal  power  of  all  powers.  At  least  three  of  my  old 
acquaintances  were  wandering  about,  and  conversed  with 
me.  It  was  a  strange  experience,  like  crossing  over  into  another 
world;  for  the  inmates  there  are  almost  dead  to  this  one.  The 
poor  fellows  I  had  known  will  never  again  be  able  to  go  beyond 
the  high  walls.  They  live  shut  out  from  the  great  active  present, 
nursing  their  strange  cfelusions.  Like  ghosts  they  seem,  wander- 
ing along  the  Stygian  banks  after  crossing  the  dark  waves  in 
Charon's  boat.  And  it  was  odd  to  think  while  in  these  halls 
and  rooms,  high-walled  courtyards,  or  open  plaza,  that,  just 
over  the  Schuylkill  River,  men  are  working  at  their  busy  occu- 


52 

pations,  little  knowing  that  on  this  bank  Julius  Caesar  still 
lives;  that  Napoleon  plots  for  universal  conquest;  Elizabeth 
envies  Mary  Stuart;  Washington  still  directs  the  affairs  of 
State ;  that  a  poor,  deranged,  long-haired  and  bearded  individual 
impersonates  Jesus  Christ.  Comparatively  few  have  assumed 
these  mighty  personalities,  but  everywhere  are  busy  and  addled 
brains  filled  with  intense  personal  interest.  That  man  is 
awaiting  a  great  fortune.  He  has  been  wronged,  but  the 
property  will  yet  be  his.  There  is  a  man  who  has  committed 
some  great  crime.  He  will  not  talk  of  it,  but  he  can  never  be 
pardoned.  That  man  is  immensely  rich.  He  owns  the  United 
States  Navy.  His  mouth  is  made  of  gold  and  all  his  teeth 
are  silver.  One  hundred  mints  cannot  contain  his  wealth, 
'Who  gave  you  these  things?'  you  ask,  'Upstairs,'  he  replies, 
and  points  skywards.  Here  comes  a  man  behind  whom  the 
Prince  of  the  Powers  of  the  Air  is  gliding.  Into  his  ear  day 
and  night  the  Evil  One  is  whispering,  but  the  possessed  man 
will  not  tell  what  the  demon  says  to  him.  That  woman,  over 
there,  talks  with  invisible  spirits  which  tell  her  of  celestial 
things.  Her  soul  is  borne  far  above  the  earth  and  soars  into 
immeasurable  regions  of  space, 

"The  evening  shadows  were  falling  over  Blockley,  as  V, 
and  I  passed  out  through  the  arched  gateway  in  the  high  stone 
wall  that  separates  the  insane  side  from  the  great  central  quad- 
rangle. Across  the  courtyard,  against  the  grey  front  of  the 
general  hospital,  a  rosy  glow  was  cast  by  the  setting  sun.  But 
the  madhouse  was  in  deep  shade,  except  where  the  reddish 
sunlight  gleamed  through  windows  opposite  to  others  facing 
-(^  westward.  These  were  lighted  up,  like  great  eyes,  with  a 
strange  and  lurid  light,  an  emblem  of  the  unhappy,  false  lives 
that  burned  fitfully,  wildly,  faintly,  within  the  long  grey  walls," 

During  the  course  of  that  winter  in  Blockley,  McL.  and  the 
diary  man,  with  Dr,  H.  of  the  Insane  Department,   rendered 


i 


53 

the  music  for  the  balls  given  for  the  insane  patients.  These 
occurred  very  infrequently,  but  may  have  brightened  up  the 
dull  routine  of  life  in  that  cheerless  department  of  Blockley. 
McL.  was  a  finished  performer  on  the  violin.  The  diary  man 
could  only  fiddle.  Dr.  H.  played  the  piano.  And  the  poor, 
crazy  people  danced!  It  was  a  weird  spectacle,  this  festiv^e 
occasion,  when  the  floor  was  occupied  by  the  mentally  deranged 
men  and  women  of  Blockley.  Most  of  the  patients  sat  quietly 
on  the  benches  placed  along  the  sides  of  the  large  hall.  Others, 
however,  were  quite  eager  to  foot  it  merrily  through  the  central 
open  space,  in  the  glare  of  the  lights,  and  to  the  music  of  our 
making.  Always  at  a  definite  hour,  on  these  evenings,  Dr.  H. 
started  a  doleful  march,  and  this  was  the  signal  for  the  close 
of  the  ball  and  the  retirement  to  wards  or  bedrooms.  It  was 
always  the  same  melancholy  recessional  that  was  rendered 
on  the  piano.  I  do  not  know  who  was  guilty  of  its  composition. 
It  was  fit  for  a  funeral.  V.  was  so  fascinated  with  its  gloomy 
measures  that  he  often  asked  me  to  play  it  to  him  on  my  fiddle, 
and  to  this  day  there  are  times  when  bits  and  snatches  of  it 
most  unexpectedly  recur  to  my  mind,  bringing  a  sense  of  sadness 
that  I  cannot  understand,  until  the  associations  of  the  music 
call  up  voices  from  an  almost  forgotten  past,  and  the  lights  and 
shadows  of  other  days. 

"One  More  Unfortunate. 

March  6,  1884. 
"Yesterday  afternoon  I  felt  sleepy.  There  was  nothing 
unusual  about  this  fact.  The  afternoons  here,  unless  there 
be  ambulance  work,  receiving  ware?  photography,  a  bad  case, 
or  clinical  notes  to  write,  are  apt  to  be  conducive  to  slumber. 
But  the  peculiarity  about  this  afternoon  was  that  Susan,  our 
useful,  middle-aged,  calm  and  experienced  woman  servant, 
with  numerous  gossips,  was  seated  in  her  room  adjoining  mine. 
The  Irish  voices  of  herself  and  guests,  never  very  subdued, 
seemed  unusually  loud. 


54 

"'Yis,'  some  one  said,  'she  was  very  unfort'nit.  The  young 
feller  hain't  bin  heard  on  agin.' 

"'Well!'  remarked  Susan,  'she  wasn't  like  to  thim  bould 
things  thet  has  more'n  one  child.  The  fust  one  don't  so  much 
matter, — '  (a  chorus  here  from  the  guests  of  'Oh,  no!  Divil  a 
bit!').  'It's  a  misfortune,  or  the  likes,'  continued  Susan,  'but 
after  the  woman  knows  what  it  means  there's  no  excuse!' 

"This  sentiment  met  with  warm  and  hearty  approval.  The 
idea  seem^ed  to  be  that  any  woman,  in  the  daily  experiences 
that  make  up  life,  might  become  the  mother  of  her  first  and 
illegitimate  child.  That  was  a  'misfortune' ;  nothing  more. 
Woe  to  the  reputation  of  any  vv^oman,  however,  who  repeated 
the  offense.  For  her  there  was  no  excuse.  As  I  suspect  that 
most  of  the  company  present  had  been  unfortunate  in  respect 
to  this  'misfortune,'  their  ideas  of  virtue  were  apt  to  rest  on 
a  broad  and  charitable  foundation.  Yet  the  conversation 
wd.s,  interesting  as  an  indication  of  the  standard  of  morality 
of  the  Blockley  class.  It  is  possible  that  it  prevails,  also,  among 
a  large  body  of  individuals  who  live  in  the  rough  and  tumble 
of  uncultured  and  laborious  lives. 

"While  I  had  charge  of  the  Erysipelas  wards,  in  which, 
also,  cases  of  any  suspected  contagious  disease  were  kept,  a 
young  woman  was  brought  in  who  was  suspected  of  having 
scarlatina.  This  she  did  not  have,  but,  as  the  patient  was 
weak,  feeble,  anaemic,  and  very  wretched,  I  kept  her  in  the 
ward  and  gradually  built  up  her  weakened  condition  with  the 
best  food  I  could  get,  together  with  quinine  and  iron  and  atten- 
tion to  her  general  health.  She  was  most  anxious  to  get  well, 
on  account  of  a  poor,  little,  sickly  baby  which  she  had  added 
to  the  world's  population  only  a  few  months  before.  At  this 
time,  there  was  only  one  other  patient  in  that  ward.  This 
one  was  an  old  hag  from  the  street.  The  young  woman,  although 
poverty-stricken,  was  married  and  respectable.  The  old  one 
certainly  had  never  stood  before  the  marriage  altar,  and  was 


55 

born  disreputable.  Such  a  congenital  condition  seems  quite 
possible  from  my  observations  here.  One  morning,  I  asked 
the  young  woman  how  many  children  she  had  had.  'Six,' 
she  answered.  The  old  hag,  who  had  been  listening,  suddenly 
groaned  aloud,  and  exclaimed  in  tones  of  heartfelt  indignation, 
'Arrah,  thin!  and  how  can  inny  woman  be  so  keerlessf" 

"  Inconvenient  Philanthropy. 

March  9,  1884. 

"While  walking  along  the  hospital  front,  on  Vintage  Avenue, 
yesterday,  I  met  two  highly  excited,  elderly,  widow-looking 
women,  who  flew  at  me  with  the  information  that  'That  man,' 
pointing  to  a  tall,  rather  well-dressed  individual  who  was  in 
advance  of  me,  that  'That  man  had  a  holt  on  a  young  baby 
done  up  in  brown  paper!'  Telling  the  ladies  to  calm  them- 
selves, and  to  feel  no  surprise  whatever  at  a  little  thing  like 
that,  as  such  objects  might  be  picked  up  at  any  moment  about 
here,  I  went  on  to  the  House  Agent's  office.  The  tall  gentle- 
man had  just  entered.  He  bowed  pleasantly  to  the  assembled 
officials  and  subalterns,  and  said  in  rather  a  chippy  way,  'I 
found  this  little  object  on  a  bridge  near  here;  and,  as  it  seemed 
to  have  no  owner,  I  thought  I  would  bring  it  over.'  He  held 
out  the  'little  object,'  which  was  in  reality  an  undeveloped  and 
evidently  still-born  child.  Perfect  silence  reigned  as  he  held 
out  the  bundle,  and  every  one  looked  at  it  critically.  Finally 
some  one  asked,  'Well,  what  are  you  going  to  do  with  it?'  A 
rather  startled  look  broke  over  the  man's  face,  and  he  said, 
'Why,  sir!  Why,  I  thought  I  would  leave  it  here!  I  think, — 
I  thought, — well,  the  fact  is, — ' 

"  'No,  sir,'  emphatically  said  the  doorkeeper,  'we  don't 
take  no  dead  ones  in  this  place.' 

"Now  for  the  first  time  the  dreadful  possibilities  of  the  situa- 
tion seemed  to  dawn  upon  the  unfortunate  man.  'But,  my  dear 
sir!'   he   sputtered,    'what  in   Heaven's   name  shall   I   do   with 


56 

it?  I  saw  a  crowd  of  people  looking  at  something.  It  turned 
out  to  be  this.  So  I  picked  it  up  and  brought  it  along.  No 
one  else,'  he  added,  with  a  look  of  injured  innocence,  'no  one 
else  would  touch  it.' 

"'It  would  a  been  a  d — d  sight  more  convenient  for  you  if 
you'd  done  like  no  one  else,'  coolly  remarked  the  doorkeeper. 

"  'If  I  can't  leave  the  thing  here,'  cried  the  now  thoroughly 
wretched  man,  'where  can  I  dispose  of  it?  I  can't  walk  in 
the  street  with  this.  I  can't  throw  it  away,  for  fear  of  suspicions 
being  attached  to  me.  I  can't  take  it  home.  I  don't  dare  to 
go  to  a  police  station,  lest  unpleasant  consequences  result.' 

"In  his  agitation  he  strode  up  and  down  the  room  gesticulat- 
ing with  one  hand,  while,  in  the  other,  he  held  the  filthy  bundle 
stifiQy  off  from  his  side. 

"'This  is  a  dreadful  situation,'  he  muttered.  'Can't  you 
advise  me?' 

"'Don't  know,'  said  the  uncompromising  doorkeeper. 
'Better  take  it  to  the  police.     Can't  do  nothing  for  you  here!' 

"Once  more  into  the  street  went  the  haunted  man.  Later 
I  heard  that  he  met  the  Warden  near  the  hospital,  and  tried 
as  a  last  resort  to  persuade  that  ever  amiable  but  diplomatic 
man  to  hold  the  bundle  'just  for  a  moment.'  He  was  last  seen 
walking  up  Thirty-fourth  Street  with  the  'little  object'  swinging 
in  time  to  his  rapid  steps.  Who  knows?  Perhaps  he  is  still 
striding  on;  afraid  to  leave  his  burden;  afraid  to  remain  with 
it;  fearing  to  take  it  home;  unable  to  rid  himself  of  his  dreadful 
load,  while  every  moment  the  horror  is  deepening  and  the 
situation  growing  more  desperate.  It  is  to  be  hoped  that 
he  fell  into  the  hands  of  a  sympathetic  policeman,  and  is  now 
free  of  his  bundle  and  still  possessed  of  his  reason." 

"On  Duty  at  the  Seventh  Street  Office. 

March  22,  1884. 
"  It  was  a  very  rainy  morning,  and  consequently  we  expected 


57 

a  rather  larger  delegation  of  maimed,  halt,  and  blind,  than  have 
of  late  been  presenting  themselves  as  objects  for  our  considera- 
tion. The  Board,  composed  of  the  House  Agent  and  myself, 
came  to  order  at  half  past  ten  o'clock. 

"Case  1.  An  old  soldier;  fought  for  his  country;  entitled 
therefore  to  special  notice;  paralyzed;  destitute  condition; 
poor  but  most  respectable;  never  expected  to  come  to  this. 
So  much  for  his  own  story  and  opinion  of  himself.  Now,  in 
fact,  he  turned  out  to  be  a  case  of  old,  long-standing  fracture 
of  the  thigh,  a  regular  old  bummer.  Finding  that  the  paralysis 
dodge  would  not  work,  he  assumes  a  very  gentle  manner,  as 
one  using  careful  management  over  something  that  might  go 
off  suddenly  and  throw  him  out,  but  which  he  purposes  to 
manipulate  by  tact.  His  manner  was  a  kind  of  apologetic 
superiority.  With  an  air  of  profound  secrecy  he  slides  his 
hand  deep  into  an  inside  pocket  of  his  long,  greasy,  dank,  and 
sodden  overcoat.  Eyeing  me  while  thus  engaged,  he  says, 
'I'll  show  you  something.'  He  speaks  almost  tenderly.  I'm 
a  wilful  child.  He  will  reason  with  my  juvenile  prejudice  and, 
incidentally,  he  will  play  his  trump  card.  Having  fumbled 
about  for  a  moment,  he  slowly  draws  out  his  hand  as  though 
it  held  something  almost  sacred.  It  is  out  at  last.  With  a 
whispered,  'Look  at  that!'  he  presents  to  my  gaze  a  six-ounce 
bottle  containing  a  very  closely  packed  and  uncomfortable- 
looking  tapeworm.  In  a  husky  voice  he  says,  'The  head  re- 
mains!' But  no!  It  is  surely  a  pity  to  disappoint  such  in- 
genuity, but  the  head  will  not  at  present  be  removed;  at  least 
not  at  Blockley. 

"Case  2.  Some  one  is  slowly  stumping  up  the  stairs. 
Slowly,  painfully,  one  foot  dragged  after  the  other.  Gradually 
a  man's  head  emerges  above  the  landing,  and  soon  the  whole 
total  wreck  stands  tottering  before  me. 

"'What's  the  matter,  are  you  sick?'  'Well  (a  long  gasp), 
if  I  ain't  sick,  there  ain't  nobody  lives.     I'm  just  knocking  about. 


58 

I've  no  place,  no  place.  I've  lost  my  common  senses  and 
I'm  near  a  loony!'  He  speaks  in  a  weak,  low,  spiritless  tone, 
and  gives  an  unexpected  emphatic  drawl  on  certain  words. 
'I  ain't  bin  so  bad  'til  last  night,'  he  continues.  'Then  I  fell 
on  me  back,  and  the  spine  of  me  back  is  broke.'  Mr.  B.,  the 
House  Agent,  talks  some  time  with  him  in  regard  to  his  means 
of  support.  'I  didn't  take  a  stitch  of  clothes  off  me,  I  may 
say,  since  Christmas,'  he  announces  in  a  sort  of  general  and 
indefinite  way.  In  a  final  and  overwhelming  burst  of  despair, 
the  old  man  moans  out,  'Ach,  the  spine  of  me  back  is  gone 
and  I  hain't  got  a  tooth  in  me  head!' 

"I  think  that  this  last  Vv^ail  broke  down  our  stony  hearts, 
for  we  gave  the  old  fellow  a  ticket  of  admission.  He  had 
nothing  the  matter  with  him  worse  than  senile  asthenia.  How- 
ever, when  I  catch  that,  perhaps  I  shall  realize  that  the  old 
wanderer  had  sufficient  reason  for  asking  the  City's  charity. 

"Case  3  is  a  youngish  man,  red-haired,  with  red,  blood- 
shot eyes,  unsteady  hand,  flushed  face,  and  all  the  other  unmis- 
takable signs  of  a  long  debauch.  The  whole  affair  seems  a 
great  joke  to  him,  quite  amusing  indeed.  He  has  a  brisk, 
easy,  genial  air,  and  tells  his  tale  as  one  would  a  first-class 
story. 

"'Well,  Doctor,'  says  he,  'I'll  just  tell  you!  When  I  take 
a  breath  a  pain  takes  me  right  through  the  chest;  and  the 
fact  is.  Doctor,  I've  got  something  else'  (a  sweet  smile  comes 
over  his  face).  'Yes,  I've  been  drinking,  and  my  friends  put 
me  out  this  morning.  I've  just  raised  Hell!  The  neighbors 
all  thought  the  very  Devil  was  loose.  My  friends  put  me  out, 
and  I  want  to  get  a  little  shelter.  I've  been  in  bed  since  Paddy's 
Day.' 

"I  strongly  intimate  to  Mr.  B.  that  the  gentleman  is  not 
a  very  serious  case.  'Yes,  Doctor,'  says  the  man  reproachfully, 
'I  am  sick  and  I've  got  a  sore  throat.'  He  receives  an  order 
upon  the  district  doctor.     His  disappointment  is  great,  but  he 


59 

finally  yields  gracefully  and  accepts  the  situation.  At  Seventh 
Street  we  are  ever  mindful  that  our  colleagues  do  not  excuse 
any  errors  that  the  man  on  duty  may  make  in  admitting  unim- 
portant and  uninteresting  cases.  It  is  fully  understood  among 
us  that  we  should  relegate  such  to  the  district  physicians  of 
the  City.  These  latter  can  always  order  that  a  patient  be 
admitted  to  the  hospital,  if  they  find  that  such  necessity  develops. 
"Case  4  was  a  decent,  respectable  looking  woman,  but 
with  terribly  dirty  hands,  who  suffered  from  rheumatism. 
*I  got  some  horse  liniment  to  rub  with  but  it  don't  do  no  good. 
I've  been  sick  such  a  long  time,  I've  run  short  of  funds;  can't 
do  no  work.  Here's  a  purscruption  some  one  gave  me.  I 
don't  know  if  it  would  do  any  good?'  I  copied  the  'purscrup- 
tion' for  the  use  of  the  profession  in  general. 

10  cents  worth  of  spiruts  of  juniper. 
5  cents  worth  of  oil  of  terpine  (turpentine?). 
10  cents  wurth  of  spiruts  of  wine. 

I  told  the  woman  that,  to  me,  it  appeared  that  she  had 
shown  rare  good  judgment  in  restraining  any  impulse  to  invest 
twenty-five  cents  worth  of  capital  in  this  speculation.  We 
sent  her  to  the  hospital. 

"Case  5.  A  tall,  worn-out-looking  woman  with  a  child  in 
her  arms.  She  wore  an  old  black  velvet  hat  witli  a  discouraged- 
looking,  bedraggled  ostrich  feather  hanging  from  the  back. 
A  blue  and  black  plaid  shawl  encased  her  thin  shoulders.  The 
v>'oman  works  out  in  situations  where  she  can  take  the  child 
with  her.  She  has  no  place  in  which  to  leave  it.  Her  husband 
went  to  sea,  and  has  not  been  heard  of  for  many  months.  She 
stayed  the  previous  night  at  the  Almshouse  among  the  'Casuals.' 
'I  don't  like  to  go  there  at  all.  Of  course  I  have  to  go  some- 
where.' This  is  on  account  of  the  child,  who  is  ill.  'Yes,  I  was 
over  there  before.     I  was  there  when  the  child    was  four  days 


60 

old.  I  had  no  home.  No,  I  don't  want  to  stay  long.'  The 
two  waifs,  mother  and  child,  receive  their  tickets  of  admission. 

"Case  6.  A  sad-faced,  desolate-looking  woman.  Her  story 
is  a  short  one.  'My  husband  gave  me  the  Disease.'  We 
admit  her. 

"Case  7.  A  perfect,  splendid  tartar,  a  man-killer!  Per- 
haps, too,  a  loony,  as  the  old  man  said  of  himself.  Her  dress 
is  covered  and  eclipsed  beneath  a  fiery  red  shawl.  A  bonnet 
perfectly  sublime  in  its  disregard  of  all  arrangement  and  order 
adorns  her  head,  and  she  brandishes  an  explosive-looking  cotton 
umbrella.  Her  son  is  in  the  insane  department,  and  surel}'- 
she  should  be  keeping  him  company.  She  has  merely  dropped 
into  the  ofiEice,  this  morning,  to  ease  her  mind  and  ventilate 
her  opinions.  Her  complaint  is  that  her  son  is  ill  treated  by 
Dr.  R.,  the  chief  physician  of  that  department.  Her  language 
is  torrential,  and  her  frankly  insulting  characterizations  of  the 
dignified  Dr.  R.  and  the  stately  and  courteous  Chairman  of 
the  Hospital  Committee  of  the  Board  were  amusing  in  their 
absolute  untruth,  and  want  of  proportion  even  as  good  lies. 
The  gesticulations  with  the  dangerous  umbrella  were  particularly 
telling.  'That  old  bald-headed  d — 1  R.!  goes  around  among 
the  women  like  an  Irish  rooster!  Playing  checkers  when  he 
ought  to  be  at  his  duty.  D — d  old  fool!  I'll  make  it  hot  for 
him  before  Wednesday!  Just  look  at  my  arm!  Twisted  all 
about  in  the  Poorhouse!  Spittin'  up  blood?  I've  been  spittin' 
it  up  ever  since.  Pat  Dailey's  first  cousin  can  tell  the  same 
thing.'  Mr.  Patrick  Dailey  was  one  of  the  Guardians  of  the 
Poor.  'G — d!  I'd  die  before  I'd  go  to  the  Poorhouse!  They're 
giving  them  soup  in  the  Insane  there  on  Fridays.  Ha!  Ha! 
they've  changed  fish  for  flesh!  I'm  wishin'  I'd  meet  Pat  Dailey 
here.  I'd  settle  things.  They're  a  dirty  mean  set,  that  com- 
mittee with  the  old  bloat  H.,  the  whiskey-head!' 

"Other  applicants  came  up,  the  usual  round  of  real  deserv- 
ing sufi"erers  and  the  shams;    the  latter  often  hard  to  recognize 


61 

from  the  worthy,  even  as  the  tares  look  Hke  the  wheat.  Bitter 
stories  of  want  and  sickness,  we  hear,  in  which  the  poor  souls 
struggle  on  a  little  longer  that  they  may  keep  away  from  the 
Almshouse.  Old  men,  young  weak  women;  stained,  battered, 
broken!  Like  ghosts  they  come  from  haunts  of  vice,  filth, 
disease;  yet  still  clinging  to  the  old  landmarks,  until,  at  last, 
deserted,  sick  or  dying,  absolutely  without  hope  in  life,  they 
enter  at  our  gate  and  join  the  nameless  throng  who  pass  through 
this  to  find  a  pauper's  home.  To  many  of  them  it  is  indeed, 
home,  and  its  kind  nurses  are  the  truest  friends  of  their  wretched, 
friendless  lives.  But  with  the  tragic  picture,  there  is  much,  too, 
of  comedy  at  the  Seventh  Street  gate;  and  without  doubt 
one  can  hear  more  clever  lying  in  two  hours  there,  than  at 
a  convention  of  promoters  of  the  gold  brick  business." 

"Down  in  the  Slums. 

March  30,  1884. 
"The  nearer  we  approached  St.  Mary's  Street,  the  more 
evident  became  the  fact  that  a  large  portion  of  Philadelphia's 
citizens  found  some  means  of  living  that  obviated  sweating 
of  the  brows.  The  street  itself  is  narrow,  scarce  wide  enough 
for  two  wagons  to  pass.  The  houses  on  either  side  are  of  the 
hovel  variety,  built  of  wood,  two  stories  in  height,  and  the 
fronts  slant  as  though  the  scrawny  buildings  were  about  to 
collapse  upon  their  miserable  inmates.  Some  buildings  are 
of  brick,  the  doors  reached  by  w^ooden  stoops.  Most  of  the 
doors  and  windows,  being  open,  reveal  long  vistas  into  darkness 
with  smoke  and  dirt  begrimed  walls,  or  into  filthy  dens  called 
rooms.  That  tall,  white-fronted  building,  on  the  left,  evidently 
was  once  a  church.  Like  all  the  surrounding  dwellings  it  is 
covered  with  foul  stains  and  crumbling  to  a  near  destruction. 
As  we  pass  the  'Ram  Cat,'  a  large  tenement  inhabited  b}^  blacks 
and  whites  and  containing  I  am  afraid  to  say  how  many  lodgers, 
we  become  objects  of  interest  to  the  entire  colony.     Bleary- 


62 

eyed,  besotted  women  of  both  colors  gaze  at  us  from  the  windows. 
They  lean  far  out  from  upper  stories,  and  call  to  one  another 
above  and  below  and  across  the  narrow  street  to  friends  in 
opposite  houses.  Uncanny,  deformed,  and  unwholesome-looking 
children  amble  to  the  gutter's  edge  and  make  uncouth  ges- 
tures at  us  as  we  pass.  Evil-faced  things  in  men's  clothing 
creep  along  by  the  walls  and  glare  at  us  with  stupid,  brutish 
eyes.  The  street  is  rank  with  filth  which  is  strewn  every- 
where. Through  the  gutters,  which  are  so  full  that  they  over- 
flow their  channels,  moves  a  sluggish  mass  of  thick,  opaque 
fluid  in  which  floats  decaying  animal  and  vegetable  matter. 
The  very  ground  seems  alive  with  humanity.  It  pours  up  out 
of  dark  cellars,  out  of  narrow  courts.  The  houses  on  either 
side  are  literally  packed  and  swarming  with  mankind.  The 
ambulance  stops  before  No. — ,  a  miserable,  filthy  shanty 
between  which  and  the  adjoining  house  a  narrow,  low-arched 
alley  runs  to  some  region  beyond.  Up  this  way  I  go,  till, 
arriving  at  a  still  more  unsightly  hole  at  the  rear  of  the  main 
house,  I  knock.  The  room  was  very  small  and  dark.  Its 
one  small  window  was  tightly  closed.  A  stove  occupied  the 
space  beneath  a  crowded  shelf  which  served  as  a  mantle.  On 
this  shelf  was  a  varied  collection  of  religious  emblems,  dirty 
articles  of  apparel,  and  cracked  and  broken  plates  filled  with 
half-eaten,  greasy-looking  food.  The  stove  was  without  fire 
and  plentifully  besprinkled  with  stains  from  tobacco  juice,  as 
were  also  the  walls  and  floor.  On  the  latter  was  a  perfect 
covering  of  dirt,  ashes,  debris  of  all  kinds,  tramped  down  into 
a  species  of  matting,  so  that  the  original  boards  could  scarcely 
be  distinguished.  A  table  upon  which  reposed  a  miscellaneous 
mass  of  everything,  shoes,  combs,  rags,  and  paper,  occupied 
one  corner  of  the  room,  and  along  the  same  side  were  heaps  of 
rags  and  indistinguishable  objects  in  a  vague  mass  of  blackness. 
In  another  corner  was  a  large  bed  upon  which  lay  an  old,  de- 
bauched,  drunken   and  besotted  individual,   once   a  man   and 


63 

a  blacksmith,  now  'a  tit  subject  for  the  Almshouse.'  Two 
young,  ill  favored,  hangdog-looking  men,  both  of  whom  will 
probably  be  jailed  or  hung  in  the  course  of  time  and  justice, 
lounged  about  the  room  in  company  with  a  young  woman. 
The  latter  was  quite  bedraggled  in  appearance  tind  although, 
like  most  of  the  women  of  this  neighborhood,  she  was  probably 
common  property  of  all  the  men,  had  a  not  unpleasant  face, 
and  her  voice  had  in  it  almost  a  tone  of  refinement.  This 
tone  was  noticeable,  for  she  repeated  many  of  the  men's  re- 
marks immediately  after  them,  and  thus  produced  a  startling 
contrast,  although  merely  a  refrain  to  what  they  said.  They 
were  told  to  make  the  old  man  ready  for  his  journey  across 
town,  and  this  was  soon  accomplished.  'Getting  ready'  con- 
sisted of  investing  the  legs  of  the  aged,  whiskey-wrecked,  and 
retired  blacksmith  in  a  pair  of  trousers  that  for  grease-spots 
and  stains  were  most  remarkable  and  noteworthy.  The  old 
man  expressed  some  disgust  and  disapproval  of  what  his 
heirs  were  doing  for  his  comfort,  but  being  told  to  'Shut  up,' 
that  'It's  too  late  to  kick  up  a  row  now,'  he  submitted.  The 
girl  finally  wrapped  him  up  in  a  filthy  sheet.  This  shrouding 
of  the  patient  in  a  sheet  was  evidently  an  attempt  at  gentility, 
and  did  not  meet  with  the  approval  of  the  two  sons.  However, 
the  girl  remarked  in  her  clear,  sweet  voice,  that  'It  is  a  shame 
to  send  father  out  uncovered.'  Supported  by  his  two  promising- 
looking  sons,  while  I  bore  up  his  legs,  the  old  fellow  was  lifted 
from  his  bed  and  carried  to  the  street.  What  would  have 
seemed  to  me  most  peculiar,  had  I  not  become  accustomed  to 
the  ways  and  manners  of  the  Blockley  class,  was  the  utter 
indifference  these  people  displayed  to  all  the  open  filthiness  of 
their  surroundings.  They  had  no  thought  of  shame  that  I 
should  see  that  filth-covered  bed,  or  the  dirt  about  the  room 
and  on  themselves.  It  was  all  a  part  of  their  everyday  life. 
They  had  never  been  clean,  and  never  desired  to  cultivate  the 
state  of  cleanliness.     By  the  time  that  we  reached  the  street 


64 

a  great  crowd  had  collected  and  stood  about  the  ambulance, 
which  had  been  backed  up  to  the  narrow  entrance  to  the  court. 
The  crowd  was  delighted  and  greatly  impressed  by  the  corpse- 
like appearance  of  our  burden,  and  several  remarks  were  made 
as  to  the  strong  probability  that  the  man  was  dead.  'Ah, 
there's  mony  a  dead  un  car'ed  out  there!'  remarked  an  old 
hag,  as  we  raised  the  patient  into  the  ambulance. 

"St.  Mary's  and  Alaska  Streets,  although  very  short,  must 
contain  as  many  inhabitants  as  any  ordinary  street  of  several 
times  their  proportions;  for  the  district  all  about  seems  to 
open  into  them  like  sewers  and  drains  into  wider  conduits. 
The  alley  into  which  I  went  was  a  sort  of  side  current,  and  I 
noticed  many  others  that  were  like  it." 

"Dolce  far  niente." 

May  14,  1884. 
"Spring,  indeed  Summer,  has  come ;  and,  with  the  appearance 
of  grass  and  leaves  and  birds,  the  old  pauper  inmates  of  this 
institution  crawl  forth  into  the  sunlight.  Every  morning 
the  old  wom^en  can  be  seen  along  the  front  of  their  building, 
sitting  in  groups  upon  the  cellar  windows  or  beneath  the  trees. 
Each  group  consists,  I  imagine,  of  intimate  friends  who  together 
form  distinct  social  circles  from  which  all  outsiders  are  rigidly 
excluded,  and  each  little  coterie  seems  always  to  occupy  the 
same  especial  locality.  To  these  places  they  bring  their  cans 
of  tea,  left  over  from  breakfast,  and  there  they  sit  until  dinner 
time.  One  would  suppose  that  they  would  knit  or  sew  or  do 
something  by  which  the  time  would  be  occupied;  but  no,  there 
they  remain  in  absolute  dolce  far  niente,  mumbling  and  gossiping 
together.  Professor  P.  said  that  a  friend  of  his,  when  a  resident 
physician  here,  overheard  two  old  crones  talking  together. 
I've  heard  similar  conversations  myself.  'Well,'  drawled  one, 
and  paused  to  whiff  twice  at  her  pipe,  'when  I  was  born  I  was 
that  small  that  they  could  set  me  in  a  pint  cup.' 


65 

"Her  friend  assumed  a  listless  air  of  interest,  and  inquired, 
'And  did  you  live?'  'Yes!'  replied  the  first,  with  an  air  of 
conviction,  as  though  announcing  a  weighty  fact,  'I  lived  and 
I  done  well!'  This  exemplifies  the  sort  of  pleasant  conversation 
carried  on  between  the  old  ladies  of  Blockley." 

"Co-laborers  in  the  Vineyard,  Who  Worked  and 
Slept  and  Starved  Together. 

May  20,  1884. 

"V.  has  gone  home  for  a  week,  in  order  to  look  for  a  place 
in  which  to  lay  his  head  after  his  term  at  Blockley  expires. 
And  our  terms  are  fast  expiring  at  Blockley  for  all  of  us.  R. 
and  P.  both  leave  at  the  end  of  this  month,  V.  in  July,  and  I 
shall  follow  at  the  end  of  August.  Six  new  men  have  already 
arrived;  or  rather  five  new  men  and  one  new  woman.  The 
year  has  been  a  delightful  one  in  many  respects,  especially  in 
the  daily  intercourse  of  the  members  of  our  resident  staff. 
We  have  been  a  united  family  and  free  from  domestic  jars; 
no  one  exactly  remarkable  for  brains  yet  no  one  really  dull, 
v.,  my  roommate,  is  a  most  amiable  fellow,  impulsive,  capable 
of  bursts  of  energy  but  not  steadily  energetic;  prone  to  excitable 
periods  of  high  spirits,  with  intervals  of  much  depression;  easily 
encouraged  and  easily  discouraged.  P — Ips  is  the  bright  member 
of  the  group,  even-tempered,  always  the  same,  full  of  fun,  a 
good  story-teller.  M.,  my  present  colleague  in  the  obstetrical 
wards,  is  the  scholar  of  the  staff,  well-read  in  medicine  and 
up  to  date  in  all  theories.  He  is  a  handsome  man,  with  genial 
manners,  but  disposed  to  be  argumentative  and  dogmatic. 
If  his  opinion  differs  from  yours,  he  will  tell  you  just  how  and 
why  you  are  entirely  in  the  wrong,  and  will  instruct  you  in 
the  only  right  way,  which  is  his  own,  and  is  derived  directly 
from  the  last  author  whom  he  has  read  on  the  subject  under 
discussion.  His  roommate,  R.,  is  tall,  straight  as  an  arrow, 
and  with  breadth  of  shoulders  to  correspond  with  his  height. 


66 

He  is  long  limbed  and  lean,  belongs  to  an  old  Virginia  family, 
and  has  the  best  traits  of  the  Southern  character.  Cool-headed 
as  a  prize  fighter,  he  is  the  last  man  any  one  would  care  to 
arouse  pugnaciously.  He  has  a  fund  of  negro  songs  and  stories, 
and,  although  not  talkative  except  among  friends,  he  is  quick 
to  see  the  ridiculous  side  of  a  situation.  L.  is  another  Southerner, 
coming  from  South  Carolina.  In  years,  he  is  the  oldest  member 
of  our  staff.  There  are  many  traditions  about  him,  one  of 
which  is  that  he  served  in  the  Confederate  heavy  artillery 
during  the  Civil  War.  He  is  full  of  fun  and  good  nature  and 
has  the  air  of  a  man  who  has  seen  much  of  the  world.  His 
hearty  laugh  is  a  pleasure  to  hear  and  always  rings  out  at  the 
first  hint  of  anything  amusing.  P — k — 1  is  the  typical  ladies' 
man  of  the  staff.  C,  a  rather  elderly  member  of  our  group, 
is  from  Barbados.  He  is  a  cynic,  a  doubter,  a  fault-finder, 
always  searching  for  the  truth  and  finding  it  not.  He  has 
read  much  and  can  be  entertaining  and  agreeable,  especially 
as  he  has  a  certain  dry,  Scotch-like  sense  of  humor.  H.  and  S. 
and  M — ch  are  all  agreeable  in  their  way,  and  take  their  places 
in  our  harmonious  circle.  McL.,  the  Hospital  Warden,  is  a 
young,  fine-looking  man,  with  black,  rather  inscrutable  eyes. 
He  is  a  good  violinist.  He  lives  and  moves  in  a  mist  of  diplomacy 
of  the  Machiavellian  type.  No  one  ever  heard  him  refuse  any 
request  directly.  His  assurance  that  the  matter  will  be  'attended 
to  at  once'  means  that  nothing  will  be  done.  He  is  more  like 
us,  than  as  a  superior  officer,  and  we  never  think  of  him  other- 
wise than  as  a  pleasant  companion  upon  whom  we  can  shake 
off  any  unpleasant  matter,  with  the  assurance  that,  although 
it  may  not  end  in  accomplishment,  still  it  is  off  our  hands  and 
will  not  greatly  burden  his.  Dr.  Mary  R.  is  respected  and 
liked  by  all  of  us  but  is  somewhat  apart  from  our  masculine 
circle. 

"So   much   for   the   individuals.     Collectively   we   are   said 
to  be  the  most  efficient  resident  staff  that  Blockley  has  possessed, 


67 

and  have  proved  the  advantages  of  a  competitive  examination 
as  a  test  for  appointment  over  the  old  system  of  political  or 
personal  influence.  We  are  quite  willing  to  accept  the  good 
opinion  of  the  authorities  of  the  Hospital  in  that  same  cordial 
and  frank  spirit  that  was  displayed  by  Mr.  Dandy  Jim,  that 
gentleman  of  color,  a  resident  of  South  Carolina,  who  being 
highly  complimented  upon  his  personal  appearance,  reported 
that 

'"I  looked  in  the  glass  and  I  found  it  so. 
Just  as  Massa  told  me,  oh!' 

"It  is  a  peculiar  sort  of  life  that  we  lead  together,  and  one 
which  could  be  experienced  nowhere  else  than  in  such  a  place 
as  Blockley.  Many  jolly  evenings  have  we  passed  meeting 
haphazard  in  one  another's  rooms  or  in  the  billiard  parlor. 
Our  conversation  is  not  always  directed  in  strictly  scientific 
channels.  In  the  freedom  of  friendly  intercourse  much  is 
expressed  and  related  that  would  cause  some  astonishment 
in  a  community  of  very  conventional  or  pious  people.  But 
all  of  this  is  interspersed  with  talk  of  peculiar  or  interesting 
cases  in  our  wards,  and  discussions  as  to  their  etiology  and 
treatment.  In  the  daily,  almost  hourly,  contact  with  one 
another,  we  have  learned  of  each  other's  characters,  of  all  our 
weak  points.  Then,  in  our  isolated  positions,  we  are  engaged 
in  common  work  and  interested  in  the  same  subjects.  It  is 
much  like  college  life,  yet  differs  from  the  latter  in  this  very 
fact  of  a  common  occupation.  We  have  been  a  united  family, 
not  one  row  breaking  in  on  our  general  comfort.  We  are  far 
from  being  a  mutual  admiration  society,  however,  for  I  imagine 
that  we  all  see  each  other's  faults  although  somewhat  near- 
sighted as  to  our  own.  But  this  very  knowledge  causes  us  to 
avoid  dangerous  ground,  or  to  accept  the  shock  good-naturedly 
when  we  do  touch,  or  are  touched,  upon  tender  spots.  All 
this  will  soon  be  over  and  we  shall  separate  far  and  wide,  as 


68 

hundreds  of  other  residents  have  done  before  us,  while  new 
men  come  in  to  fill  the  vacant  posts.  But  I  believe  that,  with 
the  experience  of  practice  and  insight  into  human  character 
gained  in  our  everyday  work,  we  shall  carry  away  also  the 
unseen,  almost  unfelt,  influence  of  each  other's  lives,  and  shall 
look  back  upon  our  Blockley  days  with  as  much  satisfaction 
for  the  experiences  and  friendships  as  for  the  opportunities  for 
medical  training." 

"Out  After  Game. 

June  6,  1884. 
"The  afternoon  suggested  August  in  temperature,  but  only 
June  could  produce  such  a  blue  sky  and  foliage  of  such  fresh 
and  vivid  green.  Having  loaded  two  holders  with  plates, 
I  tucked  my  tripod  under  my  arm  and  stalked  forth  after  game. 
Game  there  was  in  plenty.  All  along  the  outwards  front, 
lolling  lazily  under  the  shade  of  trees  or  walls,  or  strolling  along 
the  shadow  covered  walks,  the  old  outwarders  offered  all  that 
could  be  wished  for  in  the  way  of  ragged  picturesqueness.  Nor 
was  the  usual  requisite  amount  of  filth  wanting  to  make  the 
subjects  well-nigh  perfect.  Passing  through  the  gateway  into 
the  Hospital  yard,  I  came  upon  a  different  class  of  humanity 
yet  of  about  the  same  grade.  This  was  younger  stock.  A 
few  more  years  and  these  younger  subjects  will  be  found  across 
the  wall  advanced  one  more  degree  in  the  order  of  Pauperism. 
A  former  Superintendent  of  Blockley,  who  must  have  been 
fond  of  phrases  and  aphorisms,  once  remarked  when  speaking 
of  its  inmates,  'Once  a  pauper,  always  a  pauper.'  Over  the 
archway  of  our  entrance  should  be  carved  the  well-known 
legend,  'Abandon  all  hope  ye  who  enter  here!'  The  association 
between  Hospital  and  Almshouse  is  degrading  and  demoralizing. 
Most  of  our  patients  belong  to  the  discouraged  class  of  citizens, 
when  not  to  the  actually  vicious.  The  habit  of  looking  to  the 
Hospital  and  its  associated  department,  the  Poorhouse,  as  an 
easy  and  natural  means  of  support  develops  easily  in  people 


69 

without  pride,  energy,  aspiration,  and  without  any  means  of 
support.  We  are  well  supplied  with  habitues  who  enter  either 
Hospital  or  Almshouse  on  the  slightest  excuse,  and  the  influence 
of  this  class  of  professional  bummers,  men  and  women,  over 
the  younger  patients  with  whom  they  associate  in  the  Hospital 
is  all  for  evil. 

"On  I  went,  past  groups  of  convalescents  sitting  on  benches 
beneath  the  trees  or  lying  on  stretchers  in  shady  angles  of  the 
walls.  High  up  along  the  balconies  of  the  fire-escapes,  up  on  a 
level  with  the  tree  branches,  sat  those  less  strong  than  the 
patients  below,  who  must  be  content  to  use  these  perches. 
And  not  so  uncomfortable  are  the  lofty  seats,  for  one  obtains  a 
iine  view  there  over  the  yard  and  what  transpires  therein,  and 
there  is  always  more  or  less  of  a  breeze.  Halting  by  the  Hospital 
gate,  I  bring  my  camera  into  position  and  'take  it' ;  then  out 
into  the  great  yard  of  the  men's  outwards.  Far  off,  up  by  the 
wall  of  the  Insane  Department,  I  see  a  large  group  of  old  men, 
halt,  blind,  broken  in  every  way.  Two  are  sitting  side  by 
side,  apart  from  the  rest,  beneath  a  shadowing  tree.  This 
is  good  for  a  foreground;  then,  back  of  them,  the  larger  group, 
and,  as  a  background,  the  high,  whitewashed  wall  of  the  Insane 
Hospital,  with  its  low,  wide,  gloomy  arched  gateway  where 
stands  the  porter's  box.  All  about  are  trees  with  thick  foliage. 
The  sunshine  falls  glaringly  white  in  the  open  spaces.  There 
is  stillness  everywhere,  except  when  broken  by  the  low  hum  of 
listless  conversation.  All  this  scene  must  be  taken  ere  yet  my 
subjects  are  aware.  Carefully  the  camera  is  placed  and  focused. 
Everything  is  ready.  Just  then,  the  two  old  pals  look  up  but 
maintain  their  position.  Six  seconds,  and  I  have  them  forever. 
One  other  group  now  before  I  go!  There  is  a  heterogeneous 
collection,  all  on  one  bench.  At  its  end  is  an  individual  leaning 
forward  with  elbows  on  his  knees  and  hands  idly  clasped.  He 
may  have  been  a  pirate,  pickpocket,  or  peddler.  I  do  not 
know.     He  was  bad  at  all  events.     Next  to  him,  sitting  bolt 


70 

upright,  is  an  old  man  with  a  long  beard  and  a  rather  respectable 
face.  His  hat  is  aslant,  just  a  bit  to  one  side.  He  may  have 
seen  better  days.  Beside  him  is  a  helpless,  weak-faced-looking 
object,  incompetency  and  shiftlessness  written  all  over  him. 
Then  come  two  nondescripts,  characters  that  are  nice  and 
bummy,  but  not  especially  typical  of  any  specialization  in  the 
down  and  out  class.  I  take  them  in  one  lot,  and  then  stop  by 
the  door  of  the  store  to  have  a  short  talk  with  the  storekeeper 
and  Mrs.  H.,  the  schoolm-a'am.  The  store  contains  a  little 
of  everything.  It  is  like  a  large  country  establishment,  and 
has  groceries,  dry  goods,  pottery,  hardware,  all  the  articles 
needed  about  the  institution.  Books  are  kept  with  each  depart- 
ment and  payments  are  made  by  written  orders,  which  are 
countersigned  by  the  Superintendent.  Next  I  stray  out  through 
the  under  passages  beneath  the  Superintendent's  quarters  and 
reach  the  street.  There  is  an  attractive  view  from  the  outer 
gateway  of  the  Insane  Department,  looking  eastward.  Beneath 
the  trees  which  meet  above  it,  forming  an  arch  of  limbs  and 
foliage,  runs  the  street,  which  is  really  a  country-like  lane, 
called  Vintage  Avenue.  Along  one  side,  separated  by  a  high 
fence  and  narrow  garden,  extends  the  front  of  the  Almshouse. 
The  central  part,  with  its  Ionic  columns  and  Greek  attic,  can 
just  be  seen  high  up  above  the  level  and  gleaming  through 
the  trees  like  an  old  temple.  Beneath  the  verdant  archway 
goes  the  road  into  an  indefinite  vista,  while,  along  its  right 
side,  sloping  downwards  towards  the  river,  extend  meadows 
now  planted  with  various  crops  of  vegetables.  Going  back 
through  the  front  buildings,  I  enter  again  the  great  courtyard 
and  take  my  way  down  to  the  Hospital.  The  sick  are  still 
there,  breathing  in  the  fresh  outdoor  air,  looking  at  the  grass 
and  flowers,  hoping  perhaps  for  a  better  future.  I  am  sure 
that  the  little  children  do.  To  them  life  has  not  yet  opened  up 
all  the  horrors  of  its  possibilities.  Some  on  crutches  skip  gayly 
about  the  walks;    and  that  little,  sweet-faced  girl  lying  in  her 


71 

wheel-chair,  a  look  of  quiet  contentment  on  her  face,  was  brought 
by  me  in  an  ambulance,  last  winter,  from  a  miserable  hovel 
way  down  in  the  slums;  from  a  small  crowded  room  up  three 
flights  of  narrow,  winding,  rickety  stairs.  There  she  had 
suffered  an  existence  in  the  midst  of  foul  air,  foul  talk,  and 
foul  lives.  Beneath  a  long  awning  fastened  to  the  top  of  one 
of  the  high  walls  and  extending  out  over  quite  a  space  of  ground, 
is  seated  a  row  of  women  of  different  ages,  while  an  old  man 
in  a  rusty  long  black  coat  and  with  a  dilapidated,  worn-out, 
black  silk  hat  is  entertaining  them  with  an  eloquent  address 
or  lecture.  His  hearers  interrupt  him  with  frequent  bursts 
of  laughter  and  piquant  repartee.  The  old  gentleman's  body 
is  slim  and  spare.  His  nose  arches  downward,  like  a  beak, 
to  meet  his  pointed,  protruding  chin,  made  more  prominent 
by  his  sunken  lips  where  the  teeth  have  long  been  absent.  I 
cannot  make  out  the  subject  of  his  talk  to-day.  Generally  it 
is  a  rambling  disquisition  upon  his  own  varied  abilities  as  a 
singer,  orator,  man  of  the  world,  and  temperance  advocate. 
He  is  a  strange,  addle-brained,  harmless  old  man  who,  not 
confined  to  the  insane  side,  wanders  about  all  over  the  institution. 
He  collects  newspapers  and  gives  them  away  to  the  inmates, 
and  thoroughly  enjoys  exercising  his  power  as  a  conversationalist. 
One  of  his  chief  roles  as  an  entertainer  is  his  ability  to  sing  one 
song  in  twenty-five  different  tunes.  The  song  is  'Old  Hundred,' 
and  he  not  only  employs  this  variety  of  tunes  in  its  rendition, 
but  he  indulges  in  a  great  range  of  keys  and  variations  in  pitch. 
From  moderately  deep  but  very  strained  bass  he  soars  suddenly 
to  high,  shrieking  falsetto.  He  knows  also  a  large  number 
of  temperance  songs  in  high  praise  of  water  and  low  estimation 
of  wines  and  liquors.  He  considers  himself  to  be  one  of  the 
really  distinguished  characters  of  the  place,  and,  when  feeling 
that  an  occasion  demands  that  he  should  appear  to  full  advantage, 
he  dons  a  cap,  made  by  himself,  of  striped  ticking,  shaped 
with  a  peak  and  decorated  with  tassels  and  a  number  of  brass 


72 

objects  which  the  old  fellow  considers  to  possess  an  immense 
value.  Thinking  that,  even  with  this  remarkable  and  striking 
headgear  he  yet  lacks  the  one  thing  needful,  the  final  touch, 
to  finish  the  correct  costume  worthy  of  his  importance,  he 
formed  a  large  pair  of  spectacles  from  an  old  cigar  box  and 
fitted  it  with  window  glass  in  lieu  of  lenses.  It  is  seldom  that 
he  presents  himself  in  this  complete  and  overpowering  'war 
paint';  but,  thus  accoutred,  I  once  found  him  in  the  entrance 
hall  at  the  Front,  and,  having  my  camera  with  me,  I  persuaded 
him  by  dint  of  much  barefaced  flattery  to  step  out  upon  the 
pavement  and  'be  taken.'  So  I  have  his  picture  somewhere 
among  my  collection  standing  in  all  his  armor,  in  the  peculiar 
attitude  which  he  fancied  best  suited  his  splendid  presence. 
Poor  old  man!  His  harmless  little  life  goes  on  here  from  day 
to  day,  sheltered  from  the  rough  jeers  of  a  thoughtless  and 
heartless  world.  Here  he  is  taken  more  or  less  seriously  or 
good-naturedly,  and  I  believe  that  many  fellow  paupers,  im- 
pressed by  his  manner  and  pretensions,  value  him  almost  at 
his  own  estimate.  It  was  late  into  the  afternoon  when  I  climbed 
the  long  stairs  to  my  room,  put  the  camera  into  its  corner,  and 
fixed  up  preparatory  to  making  my  evening  rounds  through 
the  wards." 

"Conspiracy. 

June  17,  1884. 
"For  several  weeks  past  M.  has  been  desirous  of  a  grand 
combined  attack  upon  Mr.  S.,  the  Superintendent.  His  room- 
mate, R — 1,  having  gone,  M.  feels  that  it  devolves  upon  him 
to  maintain  the  aggressive  position  of  the  resident  staff  towards 
the  tyrant  of  Blockley.  Mr.  S.  has  always  regarded  us  with 
suspicion,  has  employed  his  'runners'  to  note  our  behavior 
and  spy  upon  our  acts.  A  cause  for  war  was  not  wanting, 
for  the  table,  during  the  month  passed,  has  been  growing  steadily 
weak  in  quality  although  the  supplies  have  been  abundant. 
In  January,  a  similar  condition  of  aff'airs  had  called  forth  numer- 


73 

ous  unpleasant  comparisons  from  myself  and  others,  even  in 
the  dining  room,  which,  coming  to  the  ears  of  the  ruler  and 
governor  of  the  feast,  had  aroused  his  wrath  and  indignation. 
He  summoned  us  all  to  a  conference  in  which  he  revealed  all 
the  secrets  of  his  housekeeping,  the  prices  paid  for  all  our  table 
supplies,  together  with  the  amount  of  the  appropriation  made 
by  the  Board  of  Guardians  for  our  maintenance.  He  closed 
his  very  candid  explanation  by  requesting  us  to  come  directly 
to  him  with  any  complaints  about  the  table,  in  the  future. 
All  seemed  well,  for  a  time,  but  beneath  the  apparent  candor 
of  the  Superintendent's  behavior  was  concealed  much  dark 
and  deep  distrust.  On  our  part  there  had  always  been  a  very 
positive  dislike  of  the  head  of  Blockley,  and  we  were  disposed 
to  suspect  him  of  insincerity  and  a  desire  to  make  us  uncom- 
fortable. We  did  not  like  him  and  he  did  not  like  us.  All  this 
situation  could  have  been  endured,  but  the  food  began  to 
deteriorate  again.  This  was  too  much;  tough  beefsteak, 
roast  beef  that  was  uneatable,  and  a  diet  weak  at  every  point. 
So  M.'s  opportunity  developed.  He  proposed  that  we  should 
make  a  demonstration  before  the  Superintendent,  in  order 
to  bring  him  to  terms.  M.  is  usually  a  quiet  and  peaceable 
man,  and  I  could  not  understand  his  thirst  for  the  fray.  How- 
ever, I  promised  to  join  him  with  the  rest,  mainly  to  keep 
company  and  for  the  sake  of  some  possible  element  of  amusement. 
Saturday  night  was  selected  for  the  time  of  our  explosion. 
Now  it  so  happened  that,  on  that  especial  night,  we  had  an 
unusually  excellent  dinner.  Mutton  chops  were  a  part  of  the 
fare,  of  such  good  quality  that  I  partook  of  four  of  them  and 
ate  largely  and  with  zest  of  everything  else.  My  companions 
seemed  to  be  indulging  quite  as  freely  in  the  substantial  elements 
of  our  feast.  The  absurdity  of  the  affair  struck  me  while  eating. 
Here  we  all  were,  eating  largely  of  an  excellent  dinner,  and, 
when  finished,  we  were  about  to  descend  to  the  office  of  the 
Superintendent  and  inform  that  official  that  he  was  only  half- 


74 

feeding  us,  and  that  his  viands  were  worse  than  worthless; 
that  they  were  positively  dangerous  to  our  health.  However, 
we  had  the  memory  of  many  bad  dinners,  and  we  were  about 
to  assert  ourselves  after  long  forbearance,  and  stand  up  for 
our  rights. 

"McL.,  the  Warden,  had  received  a  chop  that  was  decidedly 
questionable  as  to  freshness.  We  would  have  desired  rather 
stronger  evidence,  but  this  could  serve  as  something  right  in 
hand  for  complaint.  Suddenly  H — n  came  in  with  a  friend. 
He  ordered  steak,  as  the  chops  had  all  been  consumed.  The 
steak  appeared.  He  took  the  dish,  smelled  at  the  contents, 
exclaimed,  'My  G — d!'  and  threw  up  his  hands  in  a  gesture 
that  might  be  interpreted  as  hopeless  despair.  Of  course 
every  one  laughed;  but  M.  seized  the  dish  and,  getting  on 
his  feet,  began  haranguing  an  imaginary  Superintendent,  holding 
the  plate  in  one  hand  and  gesticulating  with  the  other.  The 
plate  was  then  passed  all  about  for  our  inspection,  and,  of 
course,  we  all  pronounced  the  steak  to  be  very  foul  and  noisome. 
M.  took  the  lead  and  we  all  stormed  down  the  stairs  to  the 
Superintendent's  office.  McL.  slipped  out  before  our  onset, 
and  had  warned  the  Superintendent  of  the  coming  fray.  Mr. 
S.  received  us  coldly,  and  with  a  frown  upon  his  face.  M.  at 
once  began  his  attack. 

"'Well,'  said  Mr.  S.,  'what  do  you  complain  of?' 

'"Well,  Mr.  S.,  I  will  begin  with  the  breakfast.  The  steak 
is  so  tough  that  no  one  can  eat  it.     The  butter  is  rancid  and — ' 

"'The  butter  is  all  right,'  broke  in  S.  'It's  the  very  best 
creamery  butter.' 

"H — n  mildly  suggests  here  that  'It  had  a  very  queer 
taste.' 

"'Yes,'  said  Mr.  S.     'That's  garlic;  it's  in  the  grass.' 

"'Mr.  S.,'  said  M.,  solemnly,  looking  the  Superintendent 
sternly  in  the  eyes,  and  speaking  as  though  he  frequently  fed 
on  grass  and  knew  its  peculiarities,   'I  never  tasted  anything 


75 

in  grass  like  that.  No,  sir,  it  is  rancid.  Then  the  milk  is 
sour  or  smoky,  and  we  can't  drink  it.  The  beef  is  never  eaten, 
but  goes  away  untouched.  To-night  the  meat  was  spoiled, 
and  had  the  odor  of — ' 

'"I  see  nothing  out  of  the  way  with  the  steak,'  interrupted 
Mr.  S. 

"Mr.  S.  has  lately  deserted  our  common  dining  room  and 
has  all  meals  served  in  his  own  private  apartment. 

"'At  the  resident  physicians'  table,  Mr.  S.,'  said  M.,  most 
severely,  'there  is  very  much  out  of  the  way.' 

"'I  have  the  same  fare  as  you,'  snapped  Mr.  S. 

"'Then,  Mr.  S.,'  said  M.  slowly,  and  with  a  tone  of  great 
sadness  in  his  voice,  'you  do  very  wrongly  and  foolishly  to 
bring  up  your  family  upon  the  kind  of  food  we  receive.' 

"'That's  my  own  affair,'  interrupted  Mr.  S.;  and  then, 
as  though  he  counted  it  as  a  telling  stroke,  he  added  sternly, 
'You  can  speak  of  me  all  you  wish,  but  you  shan't  bring  in  my 
family.' 

"M.  apologizes  instantly  for  anything  that  would  have 
implied  this  discourtesy.  The  talk  drifts  on.  We  all  take 
a  part.  It  is  finally  agreed  that  the  money  appropriated  for 
our  table  shall  be  spent  upon  a  few  really  good  articles,  with 
less  variety  and  no  unnecessary  viands.  Thus  shall  v/e  strive 
to  have  a  few  good  things  rather  than  many  indifferent  ones. 
This  seemed  very  nice,  philosophical,  and  within  good  common 
sense;  but  the  Superintendent  took  the  matter  to  the  Board 
of  Guardians,  who  referred  it  and  us  to  the  tender  mercies  of 
its  Committee  on  Diet  and  Classification.  This  committee 
considered  the  whole  affair,  and  determined  to  classify  us  as 
unreasonable  rebels,  and  the  diet  as  too  good  for  our  over- 
delicate  and  too  particular  appetites.  And  we  seemed  to  be 
on  such  very  strong  ground!  Yet  thus  failed  our  grand  demon- 
stration." 


76 

"By  the  Way. 

June  24,  1884. 
"The  Hospital  clock,  strangely  right,  has  just  struck  the 
hour  of  ten.  It  is  very  Vv'arm  to-night.  Scarcely  a  breath 
of  air  is  stirring,  just  enough  to  rustle  the  leaves  of  the  trees 
beneath  my  window.  From  far  away  somewhere  comes  the 
sound  of  a  piano,  probably  in  some  house  on  Darby  Road.  I 
am  alone  to-night.  V.  has  gone,  leaving  Blockley  forever. 
Last  evening  he  began  the  work  of  packing  his  trunk,  and 
continued  thus  engaged  far  into  the  night.  I  had  gone  to  bed 
and  to  sleep  before  the  trunk  was  filled.  Business  took  him 
to  the  City  this  morning,  and  I  met  him,  just  as  with  hands 
filled  with  plate-holders  I  was  on  my  way  to  the  pathological 
laboratory,  darkness,  and  the  red  light.  V.  was  rushing  about 
the  Hospital  in  high  spirits,  shaking  hands  with  the  nurses 
and  bidding  farewells.  I  walked  with  him  over  to  the  Front 
and  down  Vintage  Avenue  to  the  Weigher's  Corner.  He  was 
full  of  jollity  and  life,  glad  to  get  away  and  evidently  hopeful 
of  the  future.  So  I  left  him, — at  his  best.  We  have  lived 
peacefully  together,  in  the  close  association  of  roommates,  for 
almost  one  year.  He  has  many  faults  and  so  have  I,  and  we 
recognize  each  other's  defects,  but  have  never  insulted  one 
another  with  criticisms  based  upon  our  experiences  of  one 
another's  temperamental  weaknesses.  V.  has  endured  much 
discomfort  at  my  hands  without  one  word  of  protest.  When  not 
engaged  in  squeaking  and  scratching  on  my  fiddle,  I  occasionally 
fire  my  revolver  at  a  thick  target  placed  against  the  headboard 
of  my  bed.  The  only  redeeming  feature  of  my  conduct  has 
been  my  respect  for  my  roommate's  side  of  our  joint  apartment, 
I  am  sure  that  he  would  have  thrashed  me  soundly  if  I  had 
trespassed.  There  must  have  been  times  and  mental  moods 
in  which  V.  found  these  diversions  somewhat  trying  to  his 
nerves.  The  pistol  practice  has  usually  been  indulged  in  when 
he   was  away  from   the  room.     All   this  will  indicate   that  V. 


77 

Ciin  be  a  very  patient  man.  I  wish  to  remember  him  always 
in  that  mood  in  which  we  parted.  It  will  surely  be  long  before 
we  meet  again." 

There  is  a  lapse  in  the  journal  of  almost  six  months.  This 
marks  the  time  of  strenuous  service  in  the  medical  wards. 
It  was  in  the  heat  of  summer.  The  visiting  chief  had  gone  to 
Europe  for  a  vacation  tour,  and  the  doctor  of  the  diary  con- 
ducted his  ward  work  as  best  he  could  with  his  very  limited 
training. 

The  medical  wards  of  Blockley  were  among  the  most  valuable 
in  any  hospital  of  the  City  for  their  varied  experiences  in  all 
sorts  of  acute,  but  more  especially  in  complicated  chronic 
diseases.  The  necessity  for  constant  service  in  these  wards, 
study  of  the  patient's  conditions,  the  reading  of  books  and 
journals,  consumed  the  hours  of  the  long,  swelteringly  hot 
days.  When  night  came  there  was  little  desire  left  for  any 
literary  efforts  upon  the  diary.  Doubtless  it  is  the  steady 
strain  and  tedious  drudgery  of  this  service,  during  the  exhausting 
heat  of  Philadelphia's  summer,  that  influences  the  tone  of  the 
journal  when  the  young  doctor  resumes  the  record  of  his  life 
in  Blockley. 

The  term  of  work  in  the  medical  wards  lasted  four  months. 
There  was  a  wealth  of  cases  of  pulmonary  tuberculosis  that  to- 
day would  not  have  been  admitted  to  the  Hospital,  or  would 
have  been  kept  apart  in  a  separate  building.  In  those  days  tlie 
pulmonary  tuberculosis  cases  were  not  separated  from  other 
patients,  although  an  effort  was  made  to  place  most  of  them 
in  one  large  ward.  In  this  same  department  was  a  narrow 
ward,  containing  about  ten  beds,  called  the  "Drunk  Ward." 
It  was  seldom  at  any  season  of  the  year  that  most  of  the  beds 
in  this  chamber  of  horrors  were  not  occupied.  Many  of  the 
patients  were  strapped  to  the  frames  of  their  cots,  so  as  to 
restrain  them  during  the  stage  of  wild  deliriura  a  potu,  when  the 


78 

sodden  mind  is  in  a  state  of  terror  under  the  fancied  visions 
of  devils,  evil  spirits,  goblins,  snakes,  and  all  unclean  beasts, 
that  hover  about,  gibber  at  the  victim,  jump  at  him,  and  clamber 
over  his  bed.  Many  of  these  patients  we  saved  by  dint  of 
careful  watching  and  proper  medication  and  nourishment. 
The  fight  seemed  to  be  hardly  worth  the  efifort,  as  the  drunkard 
was  sure  to  return  to  his  cups,  and  a  recurrence  of  delirium 
tremens  was  as  certain  as  the  early  termination  of  the  miserable 
life.  The  fatal  cases  of  this  condition  died  usually  from  broncho- 
pneumonia, from  sheer  exhaustion,  or  from  an  intercurrent 
chronic  disease  of  the  liver,  kidneys,  or  heart;  sometimes  from 
a  combination  of  such  diseases  in  the  same  subject.  It  was 
not  a  pleasant  part  of  the  medical  service,  and  yet  always  in 
evidence  and  always  demanding  close  attention.  These  rather 
dreary  days  have  carried  the  diary  man  on  into  August,  before 
the  journal  begins  once  more  to  tell  its  story. 

"Impressions  and  Memories. 

August  5,  1884. 
"I  have  had  a  busy  afternoon.  After  working  for  about 
two  weeks  in  the  Pathological  Laboratory,  which  is  nothing 
more  nor  less  than  a  lumber  room  for  rubbish,  M.  and  I  made 
a  grand  clearing  out.  The  room  is  entered  from  the  great  clinic 
amphitheatre,  its  door  being  at  one  corner  of  the  great  square 
hall  on  a  level  with  the  upper  gallery.  The  gallery  itself,  on 
the  side  occupied  by  the  laboratory,  is  walled  with  glass  cases 
containing  specimens  in  jars  of  alcohol  of  almost  every  phase 
of  morbid  anatomy,  gathered  through  long  years  from  the 
post-mortem  room.  M.  and  I  changed  the  positions  of  tables 
and  cabinets,  so  as  to  gain  more  space  in  the  room,  moved  out 
a  mass  of  useless  material  which  dated  far  back  to  former  years 
and  had  labels  signed  with  the  names  of  resident  physicians  long 
ago  forgotten.  Then  we  swept  up  the  filthy  room,  and  J., 
my  new  roommate,  washed  the  floor  thoroughly  with  a  mop. 


79 

The  room  is  thus  much  improved,  and  will  be  more  comfortable 
and  convenient.  It  was  quite  an  act  of  unselfishness,  for  M. 
and  I  can  only  benefit  by  the  renovation  for  the  space  of  three 
more  weeks.  It  has  been  a  busy  summer  and  will  always  be 
an  isolated  one  in  my  memory.  The  departure  of  the  older 
resident  physicians,  who  belonged  to  our  special  circle,  and 
work  in  common,  have  thrown  M.  and  me  much  together. 
In  some  respects  it  has  been  the  pleasantest  part  of  my  Blockley 
experience.  Only  now  and  then  comes  a  desire  to  be  away  up 
North;  but  work  soon  causes  forgetfulness  of  everything  except 
itself.  To-night  is  a  real  August  experience,  not  quite  so  enter- 
taining as  a  midsummer  night's  dream.  It  is  hot,  close,  and 
damp.  My  gas  is  fully  lighted  and  adds  to  the  general  heat. 
Outside,  there  is  not  a  breath  of  wind.  The  leaves  hang  lifeless 
in  the  hot  heavy  air.  Lead-colored  clouds  are  above,  in  irregular 
masses  or  drawn  out  into  long  ragged  rolls.  There  is  a  constant 
low  vibration  of  insect  sounds,  broken  occasionally  at  irregular 
intervals  by  croaking  choruses  of  frogs,  coming  up  in  a  sleepy 
monotone  from  the  low-stretching  country  along  the  river.  ( 
Above  this  mixture  of  the  noises  of  a  night  in  summer,  floating  |*^ 
across  the  fields  from  Darby  Road,  comes  the  jingle  of  an  occa- 
sional street  car,  with  the  clatter  of  the  horses'  hoofs  upon  the 
cobblestones  and  the  dull  rumble  of  the  wheels.  A  few  notes  I 
of  a  far-off  piano  mingle  with  these  various  sounds  and  tend  ' 
to  increase,  instead  of  to  soothe,  the  general  sense  of  oppression 
so  characteristic  of  a  night  in  Philadelphia's  August. 

"In  contrast  to  all  this  I  cannot  help  recalling  past  summers 
at  Kennebunkport  on  the  coast  of  Maine:  the  quiet  river; 
the  old  drawbridge  and  seaweed  covered  wharves;  the  quaint 
village,  elm-shaded,  its  wide  square  houses  with  dark  cool 
rooms  within  filled  with  old  mahogany  furniture  and  with  East 
India  relics  that  recall  lives  of  old  sea-captains,  long  voyages, 
and  foreign  ports  and  return  to  quiet,  well-ordered  homes. 
They  belong  to  an  old-time  epoch,  these  homes;    but,  in  the 


80 

hush  and  twihght  of  the  present,  one  fancies  that  he  hears 
faint  voices  and  the  laughter  that  echo  the  hfe  and  gayety  and 
pleasant  social  ways  of  generations  past.  I  see  in  memory 
the  long  line  of  rocky  coast,  sweeping  away  in  circling  outline 
till  it  ends  in  a  far-off  misty  point  of  ragged  cliff.  Across  the 
bay  towers  up  the  cone-shaped,  flat-topped  form  of  Mount 
Agamenticus,  while  seemingly  at  its  very  foot  gleam  white- 
housed  villages,  with  here  and  there  a  church  spire  rising  as  a 
beacon  above  the  general  level.  Then  there  were  the  excur- 
sions, the  moonlight  nights  on  the  river,  freshened  by  sea  breezes, 
while  even  the  land  winds  were  cool,  freighted  with  the  incense 
of  pine  forests.  There  are  upland  pastures,  rocky,  covered 
with  low  scrubby  growths  of  fragrant  sweet  fern  and  blue- 
berries and  bay.  Stretching  far  and  wide,  they  lay  warm  in 
the  summer  sunshine.  From  barren,  wind-swept  summits 
wide  landscapes  spread  out,  bordered  inland  by  dim,  blue- 
lined  mountains,  seaward  by  the  ocean's  flashing,  changing,  vari- 
tinted  surface;  and  over  all  a  summer  sky  of  blue,  flecked  with 
snowy  masses  of  slowly  moving  clouds.  Away  over  the  bare, 
undulating  country,  narrow  roads  go,  winding  between  irregular 
stone  fences  over  which  wild  vines  grow  in  tangles,  some  of 
them  bright  with  flowers.  I  am  on  a  road  that  enters  a  forest 
of  tall  hemlocks  where  every  sound  seems  hushed.  To  either 
side  long  vistas  stretch  away  over  the  clean-kept  forest  floor 
strewn  with  cones  and  needles,  flecked  with  spots  of  sunlight. 
There  is  a  spring  by  the  narrow  roadway,  moss-lined,  formed 
in  a  crevice  of  the  solid  rock.  Beside  it  lies  an  ocean  shell  for 
cup,  and,  from  the  spring,  a  fine  clear  rill  of  water  flows  away 
beside  the  road  as  it  goes  onward.  There  comes  a  break  in 
the  line  of  trees;  a  turn  in  the  road;  and,  right  ahead,  through 
the  long  dark  foreground  in  perspective,  bordered  by  tall, 
gaunt,  ragged  pines,  bursts  forth  a  view  of  the  ocean's  cliffs, 
and  the  sea  itself  lies  in  purple  splendor  just  beyond. 

"These  are  some  of  my  memories,  to-night,  as  I  sit  in  my 


81 

hot,  stuffy,  hospital  room,  hearing  the  mixed,  inconsistent, 
and  incongruous  sounds  of  suburban  life.  Near  at  hand  are 
the  wards  filled  with  suffering,  complaint,  deceit,  vice,  crime, 
and  amid  all  this  wretchedness  a  few  heroic  lives  living  on  from 
day  to  day,  friendless,  dying  by  inches  in  an  Almshouse;  and 
yet  with  brave,  patient  faces,  with  sad  but  ready  smiles  awaiting 
the  end.  Good  and  bad,  these  are  my  brothers  and  sisters 
in  the  flesh,  as  God  and  afterwards  the  Devil  made  them;  filled 
with  desires,  with  lusts,  with  ardent  passions,  all  dominated 
by  intense  selfishness.  Call  them  modern  barbarians?  Nay, 
friend!  They  are  not  so  very  different  from  yourself,  your 
respected  parents,  your  brothers  and  sisters,  your  esteemed 
wife,  bereft  of  the  conventionalities  that  blossom  under  the 
mellowing  influences  of  social  culture  and  inherited  instincts 
of  refinement.  What  can  be  done  to  help  them  into  better 
living?  Thus  far  we  seem  to  play  about  the  outskirts  of  these 
vast  multitudes  with  our  Church,  our  Benevolences,  our  Science 
of  Social  Order.  The  priest  speaks  to  Christians  who  sit  on 
cushioned  seats,  object  to  any  crudities  in  the  literary  style 
or  substance  of  his  sermon,  listen  to  the  soft  ecclesiastical  music, 
view  the  mystery  on  the  marble  and  guilded  altar  lighted  by 
the  ecclesiastical  light  from  ecclesiastical  stained  and  pictured 
windows,  and  then  return  to  well-laden  tables  and  well-cooked 
Sunday  dinners.  Some  dollars  have  been  dropped  into  the 
offertory  under  an  impression  that  thus  somebody  is  going 
to  be  clothed  and  fed  and  led  to  see  a  little  of  sweetness  and 
light.  The  benevolent  direct,  contribute  money,  and  engage 
in  learned  discussions  on  the  way  to  manage  those  strangling, 
struggling,  submerged  multitudes ;  and  they  may  give  temporary 
material  help  to  a  few,  so  few  in  proportion  to  the  mass,  that 
it  resembles  a  child's  offer  of  an  apple  to  an  elephant.  They 
scratch  the  surface  of  the  vast  marsh.  But  it  needs  to  be 
drained,  trenched,  filled  in  here  and  there,  before  it  can  bear 
the  fruit  of  bettered  lives.     It  is  a  tremendous  question,  needing 


82 

management  on  a  large  scale.  I  doubt  if  anything  more  practical 
than  the  developing  of  a  mild  and  moral  amusement  for  members 
of  churches  and  private  societies  can  be  gained  by  such  effort. 
It  is  so  great  that  it  needs  the  care  of  the  nation,  of  a  government 
that  can  act  as  parent  to  this  mass  of  grown-up  and  mentally- 
delinquent  children;  a  government  that  can  educate,  separate 
the  hopeless  from  the  more  eflScient;  that  can  coerce,  compel, 
punish ;  and  all  this  on  the  basis  of  laws  that  are  just  but  which 
never  fail  of  execution. 

"Meanwhile,  there  still  exist  St.  Mary's  Street  and  Alaska, 
Bandbox  Row,  and  all  the  squalor  of  Port  Richmond,  long 
lines  of  misery  on  Front  Street,  Second  Street,  on  so  many 
streets  that  one  cannot  name  them.  It  is  at  your  next  door 
or  in  the  alley  behind  your  house. 

"And  so,  what  is  the  conclusion  of  this  August  night's 
rambling  thoughts?  I  cannot  answer.  A  year  of  Blockley 
life  stands  between  me  and  much  that  seemed  established  and 
forever,  before  I  entered  at  these  gates.  The  experience  has 
been  somewhat  demoralizing.  At  all  events,  the  experiences 
of  Blockley  and  its  inmates  and  our  vast  stretches  of  slums 
combine  to  induce  a  sense  of  contentment  that  I  am  just  a 
plain,  unimportant,  and  unknown  medicus  rather  than  a  Hamlet, 
born  to  a  station  and  responsibility  where  he  must  exclaim : — 

"  'The  time  is  out  of  joint; — O  cursed  spite! 
That  ever  I  was  born  to  set  it  right!' " 

Bacteriology  in  its  modern  aspects  was  at  the  very  beginnings 
in  the  days  of  the  diary.  The  splendidly  equipped  laboratories 
of  all  great  modern  hospitals,  with  the  efficient  specialists  in 
charge,  were  represented  by  the  very  meager  and  primitive 
appliances  described  in  the  journal.  Young  men  were  beginning 
to  visit  the  institutions  of  Germany,  and  training  thus  acquired 
was  to  develop  a  great  change  and  most  needed  improvement 
in  all  departments  of  American  hospitals  and  medical  schools, 


83 

but  especially  in  those  that  related  to  the  scientific  study  of 
Pathology  in  all  its  phases.  And  yet  the  members  of  the  resident 
staff  at  Blockley  in  that  antediluvian  time, — somewhat  better 
than  the  Stone  Age,  it  is  true, — took  themselves  and  their 
laboratory  work  rather  seriously,  although  the  modern  Patholo- 
gist would  have  been  amused,  as  well  as  saddened,  at  the  waste 
of  valuable  material  for  investigation,  the  primitive  methods  of 
work,  and  the  great  lack  of  necessary  training  and  information 
and  definite  plan  of  action  on  the  part  of  these  young  medical 
scientists. 

"The   PathoLtOgical   Laboratory;    A   Sacrifice   upon   the 
Altar  of  Science. 

August  8,  1884. 
"In  the  Pathological  Laboratory,  the  other  afternoon, 
it  was  found  that  we  had  need  of  the  fresh  blood  and  other 
tissues  of  an  animal.  The  laboratory  is  a  small,  well-filled 
room  way  ofT  in  one  corner  of  the  clinic  building.  It  overlooks 
an  old  courtyard,  high  walled  and  carpeted  with  tall  grass 
except  where  clotheslines,  hung  from  one  old  rugged  tree  to 
another,  have  caused  clearings  of  trampled  grass  to  be  made 
by  the  capacious  feet  of  the  washerwomen.  Cats,  wild  in 
nature  and  appearance,  infest  this  antiquated  and  secluded 
quarter,  and  prowl  in  the  shadow  of  the  high  stone  walls  with 
their  jutting  eaves  of  tiling.  In  the  laboratory  we  are  working 
up  the  subject  of  bacteria  culture  under  the  direction  of  Dr. 
S.  McL.  suggested  the  sacrifice  of  a  cat.  This  seemed  to 
answer  our  requirements,  and  he  and  M.  went  oflF  in  search 
of  one.  But  the  Blockley  cat  is  a  wise  animal,  and  looks  upon 
doctors  only  from  high  roofs  and  far-off  vistas.  McL.  and  M. 
returned  empty  handed,  but  they  had  set  a  small  boy  upon  the 
warpath.  His  instructions  were  to  bring  any  cat  alive,  no 
matter  from  what  quarter  of  Blockley  it  came,  except  a  certain 
black  and  white  cat  that  lives  in  the  Hospital  Kitchen.     This 


84 

cat,  being  pregnant  and  well  on  to  full  term,  was  to  be  respected. 
The  boy  returned  in  the  course  of  half  an  hour  bearing  in  his 
arms  none  other  than  the  very  forbidden  female.  He  assured 
us  that  she  was  not  pregnant;  never  had  been;  might  never 
be;  but  his  persuasive  powers  were  in  vain.  He  was  ordered 
to  take  her  back  and  produce  another  within  half  an  hour. 
The  fellow  must  have  chased  all  over  the  institution,  but  he 
appeared  finally  with  a  large,  indignant,  and  irate  Tom-cat 
struggling  and  spitting  in  his  arms.  Now  McL.  is  not  one 
of  our  scientific  circle  but  a  mere  interloper,  and  he  has  an 
agreeable  way  of  making  a  cat's-paw  of  any  one.  True  to 
his  habit,  he  now  proposed  cheerfully  that  he  would  give  the 
victim  chloroform  while  I  held  the  excited  beast.  By  this 
time  the  cat,  being  released,  had  bolted  to  the  nearest  window 
sill,  was  howling  most  dismally,  and  presented  a  perfect  battery 
of  teeth,  claws,  and  luffed  up  hair  to  any  one  who  approached. 
The  prospect  was  not  peaceful  or  pleasing,  and  I  suggested 
to  McL.  to  go  and  soothe  the  Tom  before  I  did  the  holding. 
McL.  would  rather  have  sat  on  a  hot  stove  than  touch  the 
enraged  and  frightened  Thomas.  However,  as  we  all  laughed 
at  his  backwardness,  he  finally  determined  to  attack  the  enemy. 
The  cat  was  his  own  suggestion,  and,  in  addition,  he  had  no 
especial  association  with  the  laboratory  work.  We  felt  that, 
under  the  circumstances,  he  should  be  glad  to  make  himself 
useful.  A  small,  strong  box  was  brought.  McL-  plunged  for 
the  cat,  landed  him  in  the  box,  and  called  loudly  for  me  to 
put  on  the  cover  and  pour  in  chloroform.  This  I  did,  and  the 
cat  died  without  any  evidence  of  suffering.  We  obtained 
all  the  needed  material  for  our  work,  and  then  the  poor  dead 
pussy  was  placed  in  a  clean  box,  covered  with  cotton,  and 
ordered  to  be  taken  to  the  Potter's  Field. 

M.,  J.,  and  I  are  up  in  the  laboratory  almost  every  after- 
noon, and  the  work  there  consumes  most  of  one's  time  from 
dinner  until  supper.     It  is  a  queer  place.     On  one  side  are  vessels 


85 

of  tin  and  felt  with  water  jackets.  Rubber  tubes  rui:  in  various 
directions  about  the  room  from  a  central  gas  pipe.  On  shelves 
along  one  side  arc  crowded  bottles  containing  every  imaginable 
substance  from  the  bodies  of  former  patients,  all  preserved  in 
alcohol,  labelled  with  the  names  of  former  owners,  and  awaiting 
to  be  prepared  for  the  microscope.  On  other  shelves  are  glass 
pipettes  of  every  size  and  shape,  glass  retorts  and  flasks,  test 
tubes,  and  many  strange  and  rusty  machines  long  unused  and 
the  very  uses  of  which  are  forgotten.  Tables  by  the  window 
are  covered  with  glass  slides  and  cases  of  instruments.  A 
large  cabinet  in  one  corner  holds  our  microscopes  and  the  various 
appliances  which  must  be  kept  from  dust  and  dirt.  In  the 
centre  against  one  wall  is  a  small  closet,  absolutely  light  tight, 
painted  a  dead  black  within,  and  containing  numerous  bottles 
together  with  a  large  lantern  with  red  glass.  This  is  the  finishing- 
room  for  photographic  work,  and  many  hours  have  I  spent  there 
in  developing  my  views  of  Blockley  scenery,  of  its  life  and 
customs  and  queer  inmates. 

"Such  is  the  Pathological  Laboratory;  never  a  cheerful 
apartment,  but  most  dismal  towards  the  close  of  a  dark,  wintry 
afternoon.  Then  cold,  fierce  winds  come  sweeping  down  into 
the  high-walled  courtyard,  sway  the  gaunt  old  tree  tops,  whistle 
shrilly  along  angles  and  into  corners.  The  tall,  dreary  wall 
of  the  Hospital  buildings,  with  its  blank,  dark  windows,  cuts 
off  all  western  light  and  makes  an  early  gloom  down  in  this 
retired  spot.  Then  it  is  that  the  bottles  take  on  queer  shapes; 
that  shadows  seem  to  betoken  more  than  their  full  value  of 
significance.  One  has  the  feeling  that  then,  if  ever,  the  souls 
of  departed  paupers  may  revisit  this  alcoholic  charnel-house, 
and  gaze  with  eyes  of  personal  interest  upon  the  aspect  and 
conditions  of  their  preserved  viscera." 


86 

"One  Summer  Day. 

August  16,  1884. 

"At  ten  o'clock  in  the  morning,  three  youths  ran  down 
the  long  stone  steps  of  Blockley's  front  entrance  and  walked 
rapidty  arway  down  the  shaded  lane  to  Thirty-fourth  Street. 
The  t?.llest,  about  six  feet  two  inches,  was  clad  in  dark  blue 
trousers,  along  the  outer  seams  of  which  ran  stout  but  tarnished 
gold  cording.  His  coat  was  of  some  mixed  stuff,  while  his 
head  was  covered  by  an  old  weather-beaten,  Blockley  uniform 
cap.  His  name  was  M.  The  second  youth  was  arrayed  in 
dark  trousers  with  fine  light  stripes  varying  their  duskiness. 
He  wore  a  black  diagonal  cutaway  coat,  and  sported  a  modern 
light  felt  plug  hat;  a  very  correct  costume.  This  was  P — Ips. 
The  third  was  clad  in  a  well-worn  suit  of  greyish-green  mixture, 
with  trousers  rather  bagging  in  the  knees  and  in  sad  need  of 
pressing.  A  dilapidated  old  Blockley  uniform  cap  was  his 
headgear.     This  was  the  diary  man. 

"We  took  a  car  and  rode  to  the  steamboat  landing  at  the 
Zoological  Garden,  and  came  within  an  ace  of  missing  the 
boat.  By  dint  of  rapid  walking  and  running  we  stepped  on 
board  in  time,  and  were  off  up  the  Schuylkill  River  for  Riverside. 
It  was  a  brilliant  day;  cool,  with  a  clear  atmosphere  and  a 
cloudless  blue  sky.  Every  point  on  trees  and  on  buildings 
stood  out  in  sharp  relief.  The  steel  grey  of  the  river,  with 
its  banks  of  vari-tinted  green  above  which  the  hills  rose  in 
smooth  grassy  slopes,  glistened  and  flashed  in  the  bright  sun- 
light. A  cool  breeze  blew  from  the  west  and  the  weather  was 
perfect.  On  reaching  Riverside  we  sat  down  on  the  long  porch 
of  the  ancient  tavern,  overlooking  the  grove  with  its  many 
small  tables  and  music  pavilion,  and  fortified  ourselves  with 
sherry  cobblers.  Then  we  started  for  our  walk  up  the  Wissa- 
hickon.  On  our  right  the  steep  bank  descended  directly  to 
the  river,  while  the  left  rose  in  forest-covered  heights,  and  huge 
boulders  and  cliffs  jutted  out  along  the  pathway  in  strange. 


87 

grotesque  forms.  I  had  promised  my  friends  much  good  scenery 
on  this  expedition,  and  M.  and  P — Ips  assumed  an  air  of  appre- 
ciation by  sudden  starts  and  stoppings,  dramatic  gestures, 
and  rapturous  exclamations  in  exaggeration  of  feeling  and 
expression.  They  had  their  fun  at  my  enthusiasm  for  the 
landscape,  and  our  laughter  and  joking  took  much  breath  and 
wind  that  was  needed  for  hill  climbing.  We  passed  several 
picnic  groups,  and  finally,  in  a  secluded  nook,  came  upon  a 
long,  rustic  table  at  which  were  seated  two  rows  of  girls  clad 
in  black  jerseys  and  white  dresses.  These  maidens  smiled 
very  pleasantly  upon  us,  and  P — Ips  suggested  that  they  were 
quite  ready  to  invite  us  to  dinner.  The  invitation  was  at 
once  forthcoming  to  the  extent  of  a  cordial  ofifer  of  lemonade. 
They  brought  out  a  tin  pail  and  passed  the  lemon-flavored 
drink  around.  It  was  amusing  to  see  P — Ips  standing  with  a 
whole  group  of  laughing  girls  about  him,  his  white  felt  hat 
tipped  back  on  his  head,  holding  the  half-emptied  glass  in 
his  hand  and  smiling  most  benignly  upon  his  entertainers. 
M.  was  much  admired  by  the  ladies,  and  one  black-eyed  siren, 
especially,  stole  to  his  side  and  darted  enraptured  glances  at 
his  handsome  face.  The  girls  told  us  that  they  were  the 
'Daughters  of  Veterans.'  On  being  asked  where  the  sons  were, 
they  said  that  the  sons  were  all  at  work,  but  would  join  them 
in  the  afternoon. 

"On  we  went  along  the  wild  beautiful  road  that  has  no 
equal  in  any  park  in  the  world;  that  is  like  a  remote  gorge 
among  rugged  mountains  far  from  the  haunts  of  men  and  Block- 
ley  patients.  The  cool  air  was  heavy  with  mingled  perfumes 
of  forest  and  moist  river  banks  and  flowing  stream.  It  was 
a  day  to  be  stored  away  in  memory.  Life  seemed  free  and 
before  us,  and  we  had  escaped  from  the  gloom  of  Blockley 
and  were  off  with  nature  under  the  greenwood  tree.  We  dined 
at  the  Valley  Green  Hotel,  an  ancient  road  house.  Then 
we  continued  our  walk  far  up  the  valley,  until  the  lengthening 


shadows  warned  us  that  the  afternoon  was  waning.  We  turned 
back  and  walked  in  the  cool  dusk  of  the  deep  and  now  sunless 
gorge.  A  bridge  takes  us  across  the  little  river,  and  we  climb 
the  long  hill  by  a  road  which  runs  through  woods  so  dense 
and  heavy  that  at  noon  they  are  in  twilight,  and  arrive  finally 
at  the  Wissahickon  Inn.  We  walked  all  over  the  lower  floor 
of  this  spacious  hotel  in  search  of  the  bar,  but  were  informed 
that  there  was  none.  This  news  was  quite  disappointing, 
especially  to  P — Ips  and  M.,  who  had  become  excessively  thirsty 
and  claimed  to  be  in  dire  need  of  stimulants.  Then  we  strolled 
over  to  the  railroad  station  and  returned  to  the  City  by  train, 
arriving  at  Blockley  in  time  for  supper." 

"On  the;  Eve  of  Departure;. 

August  30,  1884. 
"The  position  of  a  Blockley  resident  physician  has  always 
been  one  of  authority.  In  the  former  years,  before  the  competi- 
tive examination  regulated  the  choice  of  candidates;  in  those 
balmy  old  days  of  the  old  Board's  reign,  at  that  time  when 
every  Board  meeting  is  said  to  have  closed  with  a  wine  dinner 
or  supper;  in  those  lazy,  shiftless,  and  extravagant  days  each 
resident  doctor  had  his  especial  Guardian  who  would  always 
support  him,  and  upon  whose  friendly  and  powerful  aid  the 
young  doctor  could  call,  whenever  he  found  himself  to  be  wedged 
in  a  'tight  place,'  either  professionally  or  morally.  This  relation 
between  Guardians  and  doctors  is  said  to  have  been  so  intimate 
and  cordial,  that  the  gentlemen  of  the  Board  and  resident 
staff  got  drunk  together.  This  is  surely  a  test  of  very  close 
friendship.  If  the  pauper  inmates  of  those  times  numbered 
among  them  as  many  individuals  as  capable  of  social  and  con- 
vivial enjoyment  as  some  of  my  patients  in  wards  and  outwards, 
an  assorted  and  carefully  selected  number  of  elect  paupers 
might  well  have  joined  in  the  festive  combination  of  Guardians 
and  doctors.     The  merriment  of  the  occasion  would  not  have 


89 

been  lessened  by  their  presence.  As  a  natural  result  of  this 
close  association  between  the  Guardians  and  the  resident  doctors, 
the  latter  were  regarded  with  profound  respect  by  all  Hospital 
attendants  and  officials.  Gradually  the  resident  medical  men 
acquired  more  and  more  authority,  until  the  resident  physicians 
almost  owned  the  Hospital.  Into  such  a  place  as  this  we,  coming 
from  stations  in  which  we  had  never  held  much  authority, 
were  suddenly  placed  upon  our  merits,  not  by  appointment 
but  by  competitive  examination.  Our  relations  with  all  under- 
officials,  nurses,  and  pauper  inmates  were  almost  those  of  masters 
and  slaves.  After  living  in  such  circumstances  for  several 
months  we  became  naturally  overbearing,  dogmatic,  and,  it 
must  be  confessed,  more  or  less  brutal.  We  met  the  slightest 
curtailment  of  our  rights  with  indignant  protest.  Trouble 
came  at  last.  We  were  at  odds  with  the  Superintendent. 
But  now  there  was  no  Guardian  for  each  man  to  visit.  The 
Board  at  once  took  grounds  against  us  and  supported  the  au- 
thority of  the  Superintendent.  There  is  a  certain  degree  of 
unfriendliness  and  suspicion  that  has  developed  among  the 
heads  of  the  various  departments  of  our  institution.  This 
forms  a  rather  interesting  picture  of  phases  of  institutional 
life.  I  imagine  that  such  epochs  of  internal  strife  occur  at 
times  in  most  institutions,  public  as  well  as  private ;  the  various 
heads  of  departments  all  at  enmity,  the  under-ofificers  joining 
the  factions  of  their  respective  chiefs,  while  every  one  is  pretend- 
ing to  be  cordial  or  at  least  diplomatically  friendly.  Perhaps 
Blockley  just  now  needs  another  meeting  of  that  efficient, 
antirevolutionary  force,  the  Committee  on  Diet  and  Classification. 
M.  and  I  had  even  thought  that  we  might  experience  some 
difficulty  in  having  our  baggage  removed  from  Blockley  without 
some  troublesome  interference,  as  the  time  for  our  departure 
had  arrived.  The  authorities  could  hardly  suspect  us  of  an 
attempt  to  pack  away  a  pauper  in  our  trunks,  but  might  fancy 
that  we  had  purloined  some  bit  of  Blockley  to  serve  as  a  memento 


90 

of  our  experiences.  M.  and  I  engaged  the  express  yesterday 
afternoon,  and  this  morning  at  seven  o'clock  it  arrived.  The 
heavy  trunks  and  boxes  were  loaded  into  the  wagon,  and  our 
goods  were  passed  out  through  the  gates. 

"The  walls  of  my  room  look  bare  to-night,  and  the  room 
itself  has  a  cheerless  and  forsaken  appearance.  This  afternoon 
I  worked  for  the  last  time  in  the  laboratory,  where  I  have  spent 
so  many  afternoons.  I  could  overlook  the  quaint  old  courtyard 
with  its  high  stone  walls  and  ancient  trees.  The  cats  that 
prowled  through  its  long  grass  have  most  familiar  yowls,  and 
should  I  ever  hear  their  peculiar  pitch  of  voice,  no  matter  in 
what  corner  of  the  world,  I  shall  always  think  of  the  old,  sleepy 
court3^ard  overlooked  by  the  laboratory  with  its  preserved 
horrors.  I  finished  my  work,  summarizing  the  results  of  obser- 
vations made  during  the  month,  just  as  dusk  was  settling  down. 
For  the  last  time  there  I  heard  the  slow,  deep  tones  of  a  neigh- 
boring church  bell  ring  out  the  hour  that  suggested  supper. 
For  the  last  time,  hastening  to  respond  to  the  suggestion,  I 
put  away  the  instruments  and  closed  the  windows.  As  I  locked 
the  door  and  passed  through  the  great  empty  and  darkening 
clinic  room,  with  its  huge  amphitheatre  of  seats,  I  could  almost 
imagine  them  peopled  with  shadowy  medical  students  of  the 
past  and  future,  while  from  away  down  in  the  arena  comes 
the  memory  of  a  voice  repeating  the  oft-heard  words,  'The 
next  case,  gentlemen,  which  I  bring  before  you,  is  one  of  especial 
interest.'  The  case  will  come  in,  and  the  lecturer  will  expatiate, 
and  the  students  will  take  careful  notes  and  lose  them  on  the 
way  home;  but  there  will  be  new  men  to  assist,  for  we  are 
about  to  step  down  and  out," 

"The  Fulness  of  the  Time. 

August  31,  1884. 
"It  would  be  an  interesting  work  to  sum  up  one's  experiences 
in  Blockley  and  strike  an  average  of  how  much  good  and  how 


91 

much  bad  was  contained  in  the  result.  But  I  beUeve  that 
these  pages  record  considerable  observations  of  that  character 
and,  at  the  close,  it  might  be  well  to  drop  a  somewhat  worn-out 
subject.  The  close!  Trunks  packed  and  off  and  all  the  various 
preparations  accomplished  that  denote  the  final  breaking  up 
and  end  of  the  term  of  service!  To-morrow  closes  the  journey 
of  the  year  and  introduces  us  to  new  experiences.  P — Ips 
said  to-day,  speaking  of  changes,  that  he  had  no  desire  to  settle 
down  for  three  years  yet,  but  was  going  to  be  content  with 
'odd  jobs.'  For  his  part,  he  had  no  ambition  beyond  content- 
ment; and  if  he  had  enough  money  to  supply  food  and  to  buy 
cigarettes,  his  strong  hankerings  after  gold  and  glory  were 
but  short-lived  and  came  at  intervals.  He  is  a  philosopher, 
in  his  way,  and  one  feels  that  his  idea  of  living  is  a  very  com- 
fortable one,  at  least  in  theory.  Whether  one  could  really 
be  content  thus  is  a  question.  It  is  twelve,  midnight,  and  I 
have  just  had  a  call  to  visit  one  of  M.'s  patients  in  the  'Drunk 
Ward,'  a  miserable  sot  who  has  come  here  with  delirium  tremens, 
and  is  bellowing  and  roaring  like  a  bull.  Not  having  as  yet 
had  the  'rams,'  I  fail  to  note  much  sympathy  for  those  in  that 
unpleasant  condition.  Of  course,  one  should  have  pity  for 
the  miserable  and  afflicted;  at  least,  the  popular  idea  is  that 
one  should  have,  whether  the  misery  is  self-inflicted  or  is  the 
result  of  uncontrollable  circumstances.  But  sympathy  as  a 
sentiment  is  at  a  low  par  in  Blockley.  One  is  so  frequently 
deceived,  that  he  becomes  disposed  to  attend  to  what  is  evidently 
required,  without  much  expenditure  of  sentiment.  Regarding 
the  worthiness  of  an  inmate  for  any  more  physical  excitation, 
we  are  forced  by  sad  experience  to  regard  the  subject  in  an 
inverse  method  from  that  common  to  the  law,  and  to  consider 
him  or  her  guilty  until  innocence  is  proven.  I  imagine  that 
there  may  be  natures,  rare  it  must  be  confessed,  which  can 
progress  in  the  study  of  human  character  beyond  the  knowledge 
of  man's  evil  traits,  and  see  the  elements  of  good  even  in  the 


92 

^Yorst  characters.  This  abiUty  to  rise  above  the  conception 
of  human  meanness  and  degradation  is  certainly  a  mark  of  a 
greater  mind  than  most  of  us  possess. 

"Life  among  unmasked  humanity  reveals  a  certain  simian 
degeneration  that  gives  little  encouragement  to  look  for  regenera- 
tion and  reform.  It  has  at  least  the  advantage  of  shocking 
one's  sense  of  moral  security.  The  observation  of  human 
hoggishness  in  others  recalls  one  to  himself,  and  he  soon  learns 
that  among  a  world  of  hogs  he  himself  may  become  none  the 
least  of  the  swinish  herd.  The  study  of  humanity  in  the  rough 
can  well  weaken  one's  smug  confidence  in  himself.  Why  am 
I  not  as  bad  as  that  sot  whose  alcoholic  ravings  at  this  very 
moment  are  disturbing  the  medical  ward?  Possibly  only 
because  I  have  not  had  his  surroundings.  Why  are  the 
apparently  pure-minded  ladies  of  this  City  not  similar  to  those 
women  who  wait  in  Dandy  Hall  until  the  hour  arrives  for  the 
birth  of  their  bastard  offspring?  Is  it  possible  that  the  pure 
would  fall  if  subjected  to  temptations  and  influences  such  as 
the  impure  suffer?  But,  instead  of  hinting  at  such  a  possibility, 
if  one  could  only  believe  that  the  low  and  degraded  have  much 
that  is  good  in  their  natures  in  common  with  the  so-called 
respectable!  Perhaps  it  requires  a  much  more  extended 
knowledge  of  the  world,  a  deeper  study  of  mankind,  and  a  more 
kindly  temperament  than  I  have  had,  before  one  can  appreciate 
the  goodness  of  man.  It  certainly  requires  but  a  short  time 
to  appreciate  the  bad.  The  proper  spirit,  born  of  prolonged 
and  intimate  relations  with  various  grades  of  society,  must 
be  that  which  induces  Julian  Gray,  in  Wilkie  ColHns'  'New  Mag- 
dalen,' to  exclaim,  'Who  but  a  Pharisee  can  believe  that  he  is 
better  than  his  neighbor?  The  best  among  us  to-day  may  be 
the  worst  among  us  to-morrow.  The  true  Christian  virtue 
is  the  virtue  which  never  despairs  of  a  fellow-creature.  The 
true  Christian  faith  believes  in  man  as  well  as  in  God.  Who 
shall  dare  say  to  man  or  woman,  "There  is  no  hope  in  you"? 


93 

Who  shall  dare  say  the  work  is  still  vile,  when  the  work  bears  on 
it  the  stamp  of  the  Creator's  hand?' 

"As  yet  I  cannot  fully  appreciate  these  words.  I  am  not 
yet  educated  up  to  their  standard  of  judgment  and  their  broad 
liberality  and  hopefulness.  But  I  would  like  to  let  the  para- 
graph stand  as  an  expression  of  hope  in  fallen  humanity  which 
the  murk  of  a  year's  life  in  Blockley  envelops  with  a  cloud  of 
doubt  but  yet  not  quite  of  denial.  Life  in  the  open,  in  an 
atmosphere  free  from  close  contact  with  the  slums,  may  give 
a  clearer  and  more  optimistic  point  of  view. 

"It  is  far  into  the  night.  The  new  day  comes,  and  with 
it  I  and  my  comrades  go  forth  into  the  outside  world  again, 
among  the  ways  of  busy,  active,  robust  men.  It  is  like  one 
who  emerges  from  the  twilight  of  a  sultry  and  windless  forest 
into  the  sunlight  and  breeze  of  ocean  cliffs.  And  there  he 
sees  his  ship  ready,  straining  at  her  cables;  and  all  the  exhila- 
ration of  life  and  effort  calls  him  out  where  the  heaving,  rolling 
water  is  blue  and  to  the  far  horizon  and  into  the  unknown 
beyond." 

Almost  twenty-nine  years  have  run  their  course  since 
the  journal  of  Blockley  days  was  tossed  into  a  box  with  other 
papers  and  forgotten.  Times  have  changed.  Methods  in 
medical  and  surgical  practice  have  been  revolutionized.  The 
slums  of  Alaska  and  St.  Mary's  Streets  have  been  cleared  to 
give  place  for  a  children's  playground,  or  have  experienced  a 
change  of  population.  Russian  Jews  have  settled  where  degener- 
ates of  the  Black  and  White  races  once  lived  in  promiscuous 
intercourse.  The  large  Italian  Colony  is  quartered  to  the 
westward  of  this  area.  The  efforts  of  several  private  societies 
for  social  betterment  have  been  crowned  with  a  success  that 
should  encourage  similar  work  on  the  same  lines  but  on  a  much 
more  extended  scale  and  affecting  larger  areas  of  the  widely- 
extended  slum  districts. 


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